Financial Protection and National Health Insurance Scheme Enrollment in Nigeria

Abstract

This study explores the impact of National Health Insurance Scheme NHIS enrollment on financial protection against the out-of-pocket expenditures and catastrophic health costs for enrollees in Nigeria. It employs Two part model (TPM) which is often used to analyze healthcare expenditures, especially when a significant portion of the population may not incur any expenses. The study employed a cross-sectional survey design with multi-stage cluster sampling to collect data, using 468 respondents comprising 234 HNIS-insured Federal Government employees and 234 uninsured employees from the organized private sector in Kano state, Nigeria. Pre-estimation and post estimation test including the skewness and kurtosis test for normality, breusch-pagan test for homoscedasticity, variance inflation factor test for multicollinearity and the combine marginal effect conducted and estimated revealed high level of consistency and reliability of the research findings. Empirical findings from the model revealed that health insurance enrollment is associated with 14.11% reduction in probability of incurring catastrophic health expenditure among the sampled respondent. Findings regarding other significant variables in the model shows that Hospitalization, health problem, and chronic health condition increases the risk of catastrophic health expenditure as expected, which highlights the potentiality of health insurance enrollment in providing financial protection against it. Education and income have positive effects on catastrophic health expenditure suggesting that higher-income and the more educated household may be more likely to incur high healthcare cost. In essence, this study recommends that,s Policymakers should prioritize increasing funding for program expansion to include wider populations because the evidence that NHIS significantly improves access and financial protection suggests that expanding and improving the implementation of NHIS is crucial for achieving Universal Health Coverage (UHC) in Nigeria.