ASSESSMENT OF CLIENTS’ SATISFACTION AND QUALITY OF OUTPATIENT CARE UNDER THE NATIONAL HEALTH INSURANCE SCHEME AT BARAU DIKKO SPECIALIST HOSPITAL KADUNA

(A CASE STUDY OF KADUNA STATE)

By

Author

Presented To

Department of Medicine

ABSTRACT
Its widely acknowledge that the performance of a national health system is largely determined by its financing mechanism. Hence, the Federal government through the NHIS is implementing a social health insurance programme and hopes to achieve a more flexible, more innovative and more competitive response to the health sector in order to ensure that every Nigeria has access to quality healthcare, that families are protected from the financial hardship of huge medical bills, ensure equitable distribution of healthcare costs among different income groups, improve and harness private sector participation in the provision off health services, equitable distribution of healthcare facilities within the federation, ensure availability of funds to the health sector for improved services. The study was conducted to assess the Knowledge and quality of outpatient care from the perspective of the NHIS clients, health providers and health managers under the scheme at Barau Dikko Specialist Hospital Kaduna. Five years after the commencement of the scheme, although the level of awareness is very high, 41.7% of the NHIS enrollees, 48.6% of the healthcare providers and 55.6% of the healthcare managers of the facility were knowledgeable on various aspects of the operation of NHIS. The NHIS enrollees and healthcare providers of the facility rated positive staff attitude, adequate information/communication about services and technical competence of the healthcare provider as the most important quality indicator in the outpatient care whereas the healthcare managers are looking at quality of care in the direction of improved funding, provision of physical infrastructure and having adequate trained personnel. Majority of the enrollees said that past experience and high expectations are the main reasons for choosing the hospital during registration. The of rate utilization of outpatient care of 38% per annum by NHIS clients shows some improvement while the pattern of utilization is more of re-visit with the referrals very low. The level of NHIS enrollees’ satisfaction with outpatient care services in facility is 43%. The awareness of the existence of the scheme was very encouraging; however, this was not translated into knowledge of the principles of the operation of the scheme, these therefore call for an aggressive publicity drive and intensive educational campaigns. This study showed that client satisfaction with outpatient care under NHIS is largely determined by the knowledge of the rudimentary principles of the operation of the scheme.