Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria

Abstract

Aims: Factors that influence the personal choice of a health care facility among health care consumers vary. Currently, what influences the choice of health facilities among enrollees under the National Health Insurance Scheme (NHIS) is not known. This study aimed to as-sess what influences the choice of facilities in the NHIS of Nigeria.

Methods: This was a descriptive cross-sectional study conducted among enrollees in selected NHIS facilities in the 11 Local Government Areas (LGAs) of Ibadan, Nigeria. A total of 432 enrollees were selected and were interviewed. A WHO-USAID semi-structured interviewer-administered questionnaire was used to obtain relevant data. Data collection was between Oc-tober and December 2019. Data were analyzed using STATA version 12.0 (α =0.05).
Results: At unadjusted OR, older respondents (OR 3.24, CI = 2.52-4.18, p = <0.0001), and those who had attained the tertiary level of education (OR 3.30, CI 2.57-4.23, p <0.0001) were more likely to make a personal choice of health care facilities. A similar pattern was ob-served among respondents who were in the high socioeconomic group (OR 4.10, CI 3.01-5.59, p = <0.0001). However, at Adjusted OR, only high socio-economic status was a predic-tor of personal choice of health care facility (OR 1.92, CI 1.21-3.05, p = 0.005).

Conclusion: This study is suggestive that a need for and the ability to afford the cost of care influence the choice of health facilities. Policies that promote health literacy in the general populace will enhance the capability of individuals to make a personal choice of health facili-ties. Stakeholders should prioritize this for policy.
Recommended citation: David A. Adewole, Temitope Ilori. Factors influencing the choice of facilities among enrolees of a prepayment scheme in Ibadan, Southwest Nigeria

Acknowledgments: The authors wish to acknowledge study participants for permission to interview them in the course of the data collection of this study.
Authors' contributions: David Adewole conceived and designed the study. Temitope Ilori did data collection and analysis. Both authors contributed equally to the manuscript write-up. The two authors also read through the manuscript draft the second time and agreed to the final manuscript.

Conflict of interests: None declared.