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Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement.

Publication ,  Journal Article
Nwanaji-Enwerem, O; Bain, P; Marks, Z; Nwanaji-Enwerem, P; Staton, CA; Olufadeji, A; Nwanaji-Enwerem, JC
Published in: Afr J Prim Health Care Fam Med
January 13, 2022

BACKGROUND: To improve healthcare access and mitigate healthcare costs for its population, Nigeria established a National Health Insurance Scheme (NHIS) in 1999. The NHIS remains Nigeria's leading vehicle for achieving universal health coverage; nonetheless, questions remain regarding its quality and effectiveness. Studies on patient satisfaction have served as a useful strategy to further understand the patient experience and the efficacy of health systems. AIM: To synthesise current knowledge on patient satisfaction with the NHIS. METHODS: The authors performed a systematic review of primary literature from 1999 to 2020 reporting on NHIS patient satisfaction in eight databases (including PubMed, Embase, and Africa-wide Information). RESULTS: This search returned 764 unique records of which 21 met criteria for full data extraction. The 21 qualifying studies representing 11 of the 36 Nigerian states, were published from 2011 to 2020, and found moderate overall satisfaction with the NHIS (64%). Further, when disaggregated into specific domains, NHIS enrolees were most satisfied with provider attitudes (77%) and healthcare environments (70%), but less satisfied with laboratories (62%), billings (62%), pharmaceutical services (56%), wait times (55%), and referrals (51%). Importantly, time trends indicate satisfaction with the NHIS is increasing - although to differing degrees depending on the domain. CONCLUSION: The beneficiaries of the NHIS are moderately satisfied with the scheme. They consider it an improvement from being uninsured, but believe that the scheme can be considerably improved. The authors present two main recommendations: (1) shorter wait times may increase patient satisfaction and can be a central focus in improving the overall scheme, and (2) more research is needed across all 36 states to comprehensively understand patient satisfaction towards NHIS in anticipation of potential scheme expansion.

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Published In

Afr J Prim Health Care Fam Med

DOI

EISSN

2071-2936

Publication Date

January 13, 2022

Volume

14

Issue

1

Start / End Page

e1 / e10

Location

South Africa

Related Subject Headings

  • Universal Health Insurance
  • Patient Satisfaction
  • Nigeria
  • National Health Programs
  • Insurance, Health
  • Humans
  • Health Services Accessibility
  • Ghana
  • 4203 Health services and systems
 

Citation

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Nwanaji-Enwerem, O., Bain, P., Marks, Z., Nwanaji-Enwerem, P., Staton, C. A., Olufadeji, A., & Nwanaji-Enwerem, J. C. (2022). Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. Afr J Prim Health Care Fam Med, 14(1), e1–e10. https://doi.org/10.4102/phcfm.v14i1.3003
Nwanaji-Enwerem, Onyemaechi, Paul Bain, Zoe Marks, Pamaji Nwanaji-Enwerem, Catherine A. Staton, Ayobami Olufadeji, and Jamaji C. Nwanaji-Enwerem. “Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement.Afr J Prim Health Care Fam Med 14, no. 1 (January 13, 2022): e1–10. https://doi.org/10.4102/phcfm.v14i1.3003.
Nwanaji-Enwerem O, Bain P, Marks Z, Nwanaji-Enwerem P, Staton CA, Olufadeji A, et al. Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. Afr J Prim Health Care Fam Med. 2022 Jan 13;14(1):e1–10.
Nwanaji-Enwerem, Onyemaechi, et al. “Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement.Afr J Prim Health Care Fam Med, vol. 14, no. 1, Jan. 2022, pp. e1–10. Pubmed, doi:10.4102/phcfm.v14i1.3003.
Nwanaji-Enwerem O, Bain P, Marks Z, Nwanaji-Enwerem P, Staton CA, Olufadeji A, Nwanaji-Enwerem JC. Patient satisfaction with the Nigerian National Health Insurance Scheme two decades since establishment: A systematic review and recommendations for improvement. Afr J Prim Health Care Fam Med. 2022 Jan 13;14(1):e1–e10.

Published In

Afr J Prim Health Care Fam Med

DOI

EISSN

2071-2936

Publication Date

January 13, 2022

Volume

14

Issue

1

Start / End Page

e1 / e10

Location

South Africa

Related Subject Headings

  • Universal Health Insurance
  • Patient Satisfaction
  • Nigeria
  • National Health Programs
  • Insurance, Health
  • Humans
  • Health Services Accessibility
  • Ghana
  • 4203 Health services and systems