Participation in the National Health Insurance Scheme Among Nurses in a Tertiary Teaching Hospital, North central Nigeria.

Background: The National Health Insurance Scheme was established under Act 35 of 1999 by the Federal Government of Nigeria and is aimed at providing easy access to health care for all Nigerians at an affordable cost through various prepayment systems. It is totally committed to achieving universal coverage and access to adequate and affordable health care aimed at improving the health status of Nigerians. Assessment of the programme after four years of operation, revealed less than three percent coverage of the Nigerian population. Therefore this study aimed at determining the level of its participation among nurses in a teaching hospital.Methodology: This was a descriptive cross sectional, facility-based study involving four hundred nurses selected using multistage sampling technique. Structured, self-administered questionnaires were used to collect data that was analysed using Epi info version 3.5.1 statistical software.Results: Majority: 268 (67%) of the respondents had good knowledge of the scheme, reflected by all of them acknowledging to having heard of the scheme with 312 (78%) actively participating in the scheme. One hundred and eighty eight (37.8%) of them had been participating for a duration of 0-2 years. A larger proportion; 216 (54%) respondents were not satisfied with the scheme with 80 (37.0%) of them noting that the process was cumbersome. There were statistically significant associations between sex (p<0.0001), cadre (p<0.0001) and participation in the scheme.Conclusion: Though all the nurses had heard about the scheme, with a greater percentage having a good knowledge of what it entails, there were negative findings regarding practice in terms of payments made and the cumbersome nature of the scheme by respondents. There is therefore a need to address these observed gaps so as to improve acceptability and accessibility of the scheme among them.Keywords: Participation, National Health Insurance Scheme, Nurses,Tertiary Teaching Hospital, North central Nigeria