Health insurance coverage and treatment seeking behaviour of people working in Port Harcourt.
Alali Aloni Adolphus1*
1Department of Community Medicine University of Port Harcourt Teaching Hospital, Port Harcourt, Rivers State, Nigeria.
*Correspondence: Dr. Alali Aloni Adolphus; +234 803 342 1555; firstname.lastname@example.org
Download full article in pdf format
Background: The health sector in Nigeria is struggling, and financing of the health systems is poor with abysmal health indices. A significantly large proportion of Nigerians still pay out-of-pocket for healthcare forcing a large proportion to seek care from cheaper unwholesome sources.
Aim: To assess the influence of health insurance coverage on treatment-seeking behaviour of workers in Port Harcourt.
Materials and Methods: The study was set amongst people who work in the formal sector of Port Harcourt and through stratified random sampling, about 250 respondents were drawn from different strata (fully insured, partially insured, not insured). Data was collected using a structured, self-administered questionnaire and analysed using SPSS version 20.
Results: Almost half of the respondents (46.3%) were within the age range of 35 to 44 years. The male to female ratio was almost 1:1 (52.5%:47.5%). 68.9% of the respondents were married. The Majority (62.7%) had either a BSc OND or NCE. They were almost all Christians (96.8%). 73.0% of the respondents where employees where they work while 9.8 % were business owners and 14.8% self-employed. Over 50% had a monthly income of above N100, 000. 73.4% of the fully insured workers and 58.3% of the partially insured workers sought health care from optimal sources (saw a qualified medical doctor) while almost half (46.3%) of the workers without health insurance sought care from unwholesome sources like self-medication, prayer houses and herbs.
Conclusion: The study concluded that there is a significant relationship between health insurance coverage and treatment-seeking behaviour of people who work in Port Harcourt and a worker with a health insurance cover is about two times more likely to seek optimal healthcare from a qualified medical doctor than a worker who is not insured.
Keywords: Heath insurance, Treatment-seeking behaviour, Moral hazards.
Cite this article: Alali Aloni Adolphus. Health insurance coverage and treatment-seeking behaviour of people working in Port Harcourt. Yen Med J. 2020;2(2):56–64.
- The World Bank. Out-of-pocket expenditure (% of current health expenditure). World Health Organization Global Health Expenditure database. https://data.worldbank.org/indicator/SH.XPD.OOPC.CH.ZS. Accessed April 13, 2020.
- World Health Organisation. Nigeria. WHO. https://www.who.int/countries/nga/en/. Accessed April 13, 2020.
- World Health Organization. Fifty-third world health assembly Resolutions and Decisions Annex. WHO. https://apps.who.int/iris/bitstream/handle/10665/260181/WHA53-2000-REC1-eng.pdf?sequence=1&isAllowed=y. Accessed April 13, 2020.
- National Population Commission, Nigeria; ICF International, USA. Nigeria Demographic And Health Survey 2013. The DHS Program. https://dhsprogram.com/pubs/pdf/fr293/fr293.pdf. Accessed April 13, 2020.
- The World Bank. Current health expenditure (% of GDP). World Health Organization Global Health Expenditure database. https://data.worldbank.org/indicator/SH.XPD.CHEX.GD.ZS. Accessed April 13, 2020.
- Omolase CO, Adeleke OE, Afolabi AO, Afolabi OT. Self Medication Amongst General Outpatients In A Nigerian Community Hospital. Ann Ibadan Postgrad Med. 2007;5(2):64-72. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4110989/. Accessed April 13, 2020.
- Federal Republic Of Nigeria. Zero Draft National Health Financing Policy 2006. Centre For Health Ethics Law and Development. http://cheld.org/wp-content/uploads/2012/04/National-health-financing-policy.pdf. Accessed April 13, 2020.
- Adekunle S. The effects of national health insurance scheme on utilization of health services at unilorin teaching hospital staff clinic, ilorin, Nigeria. Health Sci J. http://www.hsj.gr/medicine/the-effects-of-national-health-insurance-scheme-on-utilization-of-health-services-at-unilorin-teaching-hospital-staff-clinic-ilorin-nigeria.php?aid=3425. Accessed April 13, 2020.
- Jowett M, Deolalikar A, Martinsson P. Health insurance and treatment seeking behaviour: evidence from a low-income country. Health Econ. 2004;13(9):845–857. doi:10.1002/hec.862
- Nickolas S. Understanding the difference between moral hazard and adverse selection. Investopaedia. https://www.investopedia.com/ask/answers/042415/what-difference-between-moral-hazard-and-adverse-selection.asp. Updated April 3, 2020. Accessed April 13, 2020.
- Onwujekwe O, Uzochukwu B. Socio-economic and geographic differentials in costs and payment strategies for primary healthcare services in Southeast Nigeria. Health Policy. 2005;71(3):383–397. http://www.ncbi.nlm.nih.gov/pubmed/15694504. Accessed April 13, 2020.
- Smith PC, Witter SN. Health, Nutrition and Population (HNP) discussion paper. Risk pooling in health care financing: The implications for health system performance. World Bank. http://siteresources.worldbank.org/HEALTHNUTRITIONANDPOPULATION/Resources/281627-1095698140167/Chap9SmithWitterRiskPoolingFinal.pdf. Accessed April 13, 2020.
- Awosika L. Health insurance and managed care in Nigeria. Ann Ibadan Postgrad Med. 2005;3(2):40-51. http://www.ajol.info/index.php/aipm/article/view/39066. Accessed April 13, 2020.
- Jowett M, Deolalikar A, Martinsson P. Health insurance and treatment seeking behaviour: evidence from a low-income country. Health Econ. 2004;13(9):845-857. http://doi.wiley.com/10.1002/hec.862. Accessed April 13, 2020.
- Buchmueller T. Community rating, entry-age rating and adverse selection in private health insurance in Australia. Geneva Pap Risk Insur – Issues Pract. 2008;33(4):588–609. http://link.springer.com/10.1057/gpp.2008.24. Accessed April 13, 2020.
- Tipping G, Segall M. Health care seeking behaviour in developing countries : an annotated bibliography and literature review. Food and Agriculture Organization of the United Nations. http://agris.fao.org/agris-search/search.do?recordID=GB9609016. Accessed April 13, 2020.
- Ward H, Mertens TE, Thomas C. Health seeking behaviour and the control of sexually transmitted disease. Health Policy Plann.1997;12(1):19–28. https://academic.oup.com/heapol/article-lookup/doi/10.1093/heapol/12.1.19. Accessed April 13, 2020.
- OECD. Poverty headcount rates at national and international poverty lines, % of population, 1991-2012. In: OECD Review of Agricultural Policies. Paris, France: OECD Publishing; 2015. https://doi.org/10.1787/9789264227644-graph36-en. http://dx.doi.org/10.1787/9789264227644-graph36-en. Accessed April 13, 2020.
- Mackian S. A review of health seeking behaviour: problems and prospects. https://assets.publishing.service.gov.uk/media/57a08d1de5274a27b200163d/05-03_health_seeking_behaviour.pdf Accessed April 13, 2020.
- Solomon NM. Health information generation and utilization for informed decision-making in equitable health service management: The case of Kenya Partnership for Health program. Int J Equity Health. 2005;4(1):8-15. http://equityhealthj.biomedcentral.com/articles/10.1186/1475-9276-4-8 Accessed April 13, 2020.
- Tomiak M, Berthelot JM, Guimond E, Mustard CA. Factors associated with nursing-home entry for elders in Manitoba, Canada. J Gerontol A Biol Sci Med Sci. 2000;55(5):M279-287. http://www.ncbi.nlm.nih.gov/pubmed/10819318 Accessed April 13, 2020.
- Glanz K, Rimer BK, Viswanath K. Health Behaviour and Health Education. 2002. http://riskybusiness.web.unc.edu/files/2015/01/Health-Behavior-and-Health-Education.pdf Accessed April 13, 2020.