scholarly journals Urban Self-employed Social Health Insurance Program as an Option in Financing Health Care within the Informal Sector? An Insight into the Acceptability of the Scheme by the Self-employed in Rivers State, Nigeria

2019 ◽  
pp. 1-9
Author(s):  
Ikeokwu E. Anderson ◽  
Foluke O. Adeniji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
The Self ◽  
Social Health ◽  
Insurance Scheme ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Rivers State

Introduction: Health care financing in the Nigerian health sector has been a major impediment within the sector due to increasing healthcare costs. Various forms of financing mechanisms are employed within the country with majority tilting to out-of-pocket payment, which led to the launch of the National Health Insurance Scheme in 2005. The National Health Insurance Scheme has the ambition to provide universal coverage to the population in 15-20 years, but the scheme had its limitations in achieving universal health coverage because it is limited to federal government civil servants neglecting the informal sector, which includes self-employed individuals. Although other forms of social health insurance scheme are being implemented within the country such as the Community Based Health Insurance Scheme. There is no sufficient evidence on the actualization of a health insurance program specifically for the self-employed despite its presence in the health insurance package known as Urban Self-Employed Social Health Insurance Program. This study aims to ascertain the perceived impact and acceptability of the Urban Self-employed Social Health Insurance Program as a viable option in financing healthcare among the self-employed. Methodology: This was a cross-sectional descriptive study of 204 self-employed individuals who were selected from seven different trade associations in Port Harcourt using semi-structured interviewer-administered pre-tested questionnaires. A Socio-Economic Status index was used to divide the households into quintile. The respondents rated their perception about the possible benefits of health insurance from 1 (none) to 4 (high) and the willingness of respondents to enrol in a community-based health insurance scheme (elicited as a binary ‘yes’ or ‘no’ variable) was also used as a proxy of acceptability data collected were analysed using the statistical package for social science (SPSS), version 23 software. Result: A majority 201 (98.5%) of the respondents perceived that having any form of insurance has the potential to improve access to health care and affordable. Respondents gave responses rated with an average mean of 3, which translates to medium impact on financial protection, improved access to healthcare, affordability and improving quality of treatment. Most respondents 183 (89.7%) accepted the urban self-employed health insurance scheme as a strategy for financing healthcare. Conclusion: Urban Self-Employed Social Health Insurance Program appears to be a viable and acceptable method of paying for healthcare among the self-employed in Port Harcourt city of Rivers State, Nigeria.

scholarly journals Factors Affecting Enrollment in Government Health Insurance Program in Kailali District

2019 ◽  
Vol 17 (3) ◽  
pp. 388-393
Author(s):  
Deepak Raj Paudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Chronic Illness ◽  
Social Health Insurance ◽  
Social Health ◽  
Factors Affecting ◽  
Government Health ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Insurance Enrollment

Background: Health care financial burden on households is high in Nepal. High health care expenditure is a major obstacle in achieving universal health coverage. The health insurance is expected to reduce healthcare expenditure. However, only small segments of the population are covered by health insurance in Nepal.This study assessed the factors affecting enrollment in government health insurance program in the first piloted district, Kailali, Nepal.Methods: A cross-sectional survey was conducted among 1048 households located in 26 wards of Kailali district after 21 months of the implementation of social health insurance program, Nepal. The sample was selected in two stages, first stage being the selection of wards and second, being the households.Results: The higher level of household economic status was associated with increased odds of enrollment in health insurance program (ORs=4.99, 5.04, 5.13, 8.05, for second, third, fourth, and the highest quintile of households, respectively). A higher level of head’s education was associated with increased odds of health insurance enrollment (ORs = 1.58, 1.78, 2.36, for primary, secondary, tertiary education, respectively). Presence of chronic illness in the household was positively associated with increased odds of health insurance enrollment (OR= 1.29). Conclusions: The poor and low educated groups were less benefited by social health insurance program in Kailali district, Nepal. Hence, policymakers should focus to implement income-based premium scheme for ensuring equal access to healthcare.Since household with chronic illness leads to high odds of being enrolled, a compulsory health insurance scheme can make the program financially sustainable.Keywords: Enrollment; health expenditure; health insurance; inequality; Nepal.

scholarly journals Factors affecting the Utilization of Social Health Insurance by the General Population in Bhaktapur Municipality

2020 ◽  
Vol 3 (1) ◽  
pp. 42-48
Author(s):  
Punam Karanjit ◽  
Prajita Mali ◽  
Rakshya Khadka ◽  
Lisasha Poudel
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
General Population ◽  
Financial Burden ◽  
Household Head ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Insurance Scheme ◽  
Factors Affecting

Introduction:  For the reduction of financial burden and to achieve universal health care, Government of Nepal launched a security program called as Social Health Insurance Program. This study aimed to find the factors associated with the utilization of the social health insurance scheme. Methods: Descriptive cross-sectional study was conducted in the Bhaktapur Municipality ward no 2. 422 households were chosen using systematic random sampling. Questionnaires were used to measure the factors affecting the utilization. The collected data was entered in Epidata and analyzed in SPSS version 16. The data were presented in the frequency and percentage. Bivariate analysis was done to identify factors utilizing social health insurance. Factors having p value less than 0.05 was taken as significantly associated. Multivariate analysis was done to examine the association between the outcome variables. Results: Almost half of the general population (42.4 %) were utilizing social health insurance scheme and reason for not utilizing includes lack of confidence in the scheme and the services of the scheme, followed by high premium cost. Age (p=0.044), occupation (p= 0.049), wealth quintiles (p=<0.001) were found to be significantly associated with utilization of social health insurance. Logistic regression analysis showed that the odds of enrollment among very rich population group were lower than the medium (AOR 0.550, 95% CI 0.305-0.993) and rich population (AOR 0.557, 95% CI 0.316-0.981). Conclusions: Multiple factors were found to be associated with the utilization of the health insurance scheme which includes age of the household head, occupation of the household head, economic status, availability of the drugs and charge paid during their visit in the health care services, behavior showed by the health care provider, confidence in the scheme, satisfaction in the services that have been providing and source of the information.

scholarly journals The Benefits of Mandatory Health Insurance. The Institutional Approach in Albania

2015 ◽  
Vol 3 (1) ◽  
pp. 55
Author(s):  
Fjoralba Memia
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
Insurance Fund ◽  
Insurance Scheme ◽  
Social Risks ◽  
Mandatory Health Insurance ◽  
The Way

Albanian health insurance system is currently facing multifaceted challenges, standing in the way of meeting the Government’s commitment to provide basic health care to the entire population. Law no.10383, dated 24.02.2011” On compulsory Health care Insurance in the Republic of Albania”, is a major step in the process of redefining and expanding social health insurance in Albania. The Law establishes a Social Health Insurance Fund as autonomous legal person in charge of financing packages of services for social health insurance beneficiaries. Mandatory health insurance scheme as part of the social protection system has been set up in order to prevent and overcome social risks standing in the way of health care services financing. This research aims to make an analysis of the benefits in context of mandatory health insurance scheme, especially between the Compulsory Healthcare Insurance Fund and health service providers. The research also intends not only to provide a theoretical analyses of legal acts, but also presented some conclusions and concrete practical suggestions in terms of necessary changes.

scholarly journals Factors Affecting Utilization of the National Health Insurance Scheme by Federal Civil Servants in Rivers State, Nigeria

2021 ◽  
Vol 58 ◽  
pp. 004695802110176
Author(s):  
Obelebra Adebiyi ◽  
Foluke Olukemi Adeniji
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
National Health Insurance ◽  
National Health ◽  
National Health Insurance Scheme ◽  
Health Workers ◽  
Civil Servants ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Rivers State

The National Health Insurance Scheme (NHIS) of Nigeria was established in 2005. This study assessed the utilization of health care and associated factors amongst the federal civil servants using the NHIS in Rivers state. This was a descriptive cross-sectional study using self-administered questionnaires. Data were collated and analyzed using SPSS version 21.0. A Chi-square test was carried out. The level of Confidence was set at 95%, and the P-value ≤ .05. Out of a total of 334 respondents, 280 (83.8%) were enrolled for NHIS, 203 (72.5%) utilized the services of the scheme. Most 181 (82.1%) of the respondents who utilized visited the facility at least once in the preceding year. Although, 123 (43.9%) of the respondents made payments at a point of access to health care services, overall there was a reduction in out of pocket payment. Possession of NHIS card, the attitude of health workers, and patients’ satisfaction were found to significantly affect utilization P ≤ .05. Regression analysis shows age and income to be a predictor of utilization of the NHIS. Though utilization is high, effort should be made to remove payment at the point of access and improving the harsh attitude of some of the health workers.

scholarly journals Willingness to Join and Pay for Social Health Insurance Scheme Among employees in Debere Berhan Town, Ethiopia

2019 ◽  
Author(s):  
Wassie Negash Mekonnen ◽  
Mesfin Wondaferew ◽  
Adugnaw Birhane Mekonen
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Contingent Valuation Method ◽  
Social Health Insurance ◽  
Health Insurance Scheme ◽  
Social Health ◽  
P Value ◽  
Multivariable Logistic Regression Analysis ◽  
Insurance Scheme ◽  
The Government

Abstract Back ground: Social Health Insurance improves access to health services among civil servants by removing catastrophic health expenditure. In Ethiopia, only 7.3% of the population covered by health insurance. Due to this fact the government of Ethiopia initiated Social Health Insurance scheme to be applied in the formal employers and employees with compulsory membership of the scheme. This study therefore aimed to assess willingness to join and pay for social health insurance scheme among government and private employees in Debere Berhan Town, Ethiopia .Methods: Cross-sectional study was conducted .At mean time Stratified sampling technique was used to select 619 employees. A modified dichotomous contingent valuation method (CVM) was applied to elicit employees’ willingness to pay. Bi-variant and multivariable logistic regression analysis was done . Then the result at 95% CI and P value <0.05 was declared as variables have statistically significant association. Results: A total of 619 employees with response rate of 97.8% were participated in the study. About 406 (65%) of the respondents were willing to join to Social Health Insurance scheme. Of which 113 (27.8%) of employees were willing to pay the government proposed 3% premium. The employee’s average willingness to pay for social health insurance scheme was 1.88% of their monthly salary. In this study the odds of respondents who had degree and above (AOR=3.608, 95%CI 1.177-11.061), employees good perception on quality health service (AOR=3.150, 95% CI 1.140-8.699) and employees who perceive benefit packages of social health insurance as enough (AOR=5.229, 95%CI: 2.230-12 .594) were higher than the counter parts. Conclusion: Employees willingness to join of the Social Health Insurance scheme(SHIS) is low and very low number of employees agree to pay the government proposed premium for SHIS. So decision-makers should emphasize to revise the benefit packages and the premiums to be contributed. likewise insurance agency and all responsible bodies should aware the society about the importance of social health insurance for the employees.

IDENTIFIKASI PERMASALAHAN FINANSIAL PADA JAMINAN SOSIAL KESEHATAN NASIONAL

INFO ARTHA ◽  
2017 ◽  
Vol 1 (2) ◽  
pp. 111-119 ◽  
Author(s):  
Mas'udin Mas'udin
Keyword(s):  
Health Insurance ◽  
Financial Distress ◽  
Social Health Insurance ◽  
Social Health ◽  
Z Score ◽  
Financial Problem ◽  
Health Security ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Score Model

The national social health security program (JKN) is a government program that aims to provide social insurance of health care for all Indonesian people. Within three years of implementation, the JKN program has provided many benefits to the community. However, there is a financial problem indicated by the financial statements of social health insurance program, which is estimated experiencing financial distress. This study aims to identify financial problem of social health insurance program. The research used mix method that is quantitative and qualitative method with sequence explanatory design. Data is taken from Healthcare and Social Security Agency (BPJS) financial statement year 2014 - 2016, and analyzed using Altman (Z-Score) model and Zmijewski (X-Score) model. The result of the study shows that the social health security program has financial distress. Program jaminan kesehatan nasional (JKN) merupakan program Pemerintah yang bertujuan memberikan kepastian jaminan kesehatan yang menyeluruh bagi seluruh rakyat Indonesia. Dalam tiga tahun pelaksanaannya, program JKN telah memberikan banyak manfaat bagi masyarakat. Namun laporan keuangan program jaminan sosial kesehatan menunjukkan adanya permasalahan finansial, yang diduga mengalami financial distress. Penelitian ini bertujuan untuk mengidentifikasi permasalahan finansial program jaminan sosial kesehatan. Metode penelitian yang digunakan mix method, yaitu kuantitatif dan kualitatif dengan desain urutan pembuktian (sequential explanatory). Data bersumber dari laporan keuangan BPJS Kesehatan tahun 2014 s.d 2016, dan dianalisis menggunakan model Altman (Z-Score) dan model Zmijewski (X-Score). Hasil studi menunjukkan bahwa Program Jaminan Sosial Kesehatan mengalami financial distress.

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