Determinants of Social Health Insurance Uptake in Bayelsa, Nigeria: Understanding Barriers and Facilitators to Achieving Universal Health Coverage
DOI:
https://doi.org/10.54536/ajmhc.v1i1.7136Keywords:
Financial Protection, Health Financing, Policy Determinants, Social Health Insurance, Universal Health CoverageAbstract
Social health insurance (SHI) had been identified as a key mechanism for advancing universal health coverage (UHC) in Bayelsa, Nigeria. However, significant barriers to SHI uptake persist, limiting access to essential health services and financial protection for vulnerable populations. This study aimed to investigate the determinants of SHI uptake in Bayelsa State, focusing on the barriers and facilitators influencing participation and the achievement of UHC. A cross-sectional survey was conducted among 600 adult residents of Bayelsa State, utilizing a multi-stage sampling technique to gather data on socio-demographic characteristics, awareness, and perceptions of SHI. Structured questionnaires were administered through face-to-face interviews. Quantitative data were analyzed using descriptive statistics, chi-square tests, and regression analysis to identify associations between various determinants and SHI enrolment. The findings revealed that 53% of respondents did not enroll in SHI, with primary barriers including affordability (31%), lack of knowledge about benefits (25%), and awareness of the enrollment process (14%). A significant association was found between access to financial resources and enrolment status (p < 0.0001). Moreover, respondents enrolled in formal-sector SHI were more likely to extend coverage to dependents than those enrolled in informal or student insurance schemes. The study highlighted critical barriers to SHI uptake in Bayelsa State, including economic constraints and information deficits. It underscored the necessity for targeted interventions aimed at enhancing public awareness, simplifying the enrolment process, and improving financial accessibility to foster greater participation in SHI, ultimately contributing to the realization of UHC in the region.
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