Predictors of health insurance uptake among residents of Lagos, Nigeria

Abstract

Introduction Health insurance is a health-financing mechanism to protect people from catastrophic healthcare costs and limits out-of-pocket spending on healthcare, which is directly linked to poverty. This study assesses the extent of health-insurance uptake and associated factors in Lagos, Nigeria. Methods We conducted a cross-sectional survey of consenting adults residing in Lagos, Nigeria. Participants were enrolled at general outpatient clinics of four public health facilities in Lagos State. Sociodemographic characteristics and data on health-insurance uptake were obtained and grouped into uninsured, National Health- Insurance Scheme (NHIS) and Private Health-Insurance (PHI). Factors associated with health-insurance uptake was determined using chi-squared tests and logistic regression models. Statistical significance was placed at p<0.05. Results A total of 1000 respondents were enrolled in the study. Overall, 9.5% of participants had health-insurance: NHIS (5.6%) and PHI (3.9%). Males had a higher healthinsurance uptake than females (p=0.035). Respondents who were married had higher odds of health-insurance uptake than those that were single (AOR=2.23; 95% CI: 1.20–4.16; p=0.01). Similarly, respondents who had a secondary-school diploma had higher odds of having a health insurance compared to those with less than a secondary-school education (AOR=5.20; 95% CI: 1.14–23.68; p=0.03). Conclusions Our findings suggest a low rate of healthinsurance uptake in the population. Being male, married and possessing a secondary school diploma or higher were associated with higher odds of health insurance uptake. Policy measures should focus on expanding access to health insurance, particularly among the less educated and the informal employment sector.

Keywords

• health insurance
• national health insurance scheme
• private health insurance
• universal health coverage