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NHIS-HMO Enrollees' Assessment of Quality of Illness Treatment during Visit to Selected Hospitals in South-West, Nigeria

Abigail Affiong Mkperedem*, Peter B Ogunlade, Chisaa O Igbolekwu, Ogadimma Arisukwu, Abiodun Olawale Afolabi

The National Health Insurance Scheme (NHIS) and its implementation through the Health Maintenance Organizations (HMOs) is a representation of the Nigerian government attempt in ensuring quality health services are offered to all Nigerians. Yet, anecdotal evidences shows that quality of illness treatment rendered at hospitals is perceived to be low, very low or average among NHIS-HMO enrollees. Using simple random and convenient sampling technique across 9 healthcare facilities in 3 local government areas in Lagos, Nigeria, the study triangulated using survey method and In-Depth Interview (IDI) to elicit data from selected respondents. The results showed that while enrollees’ were positive to statement pertaining to the medical consultant (doctor) mannerism, explanation and examination, significant numbers were not subjected to comprehensive tests and examinations were not promptly carried out. Health plans of enrollees’ were observed to have effect on the quality of service (treatment) accessed. IDI revealed that enrollees succumb to Out Of Pocket payments (OOP) at the Health Care Facilities (HCFs) for services considered higher in quality compared to the ones covered by the scheme. As such the study recommends that government should take appropriate measures including pro-active inspectorate division to ensure that accredited Health Care Providers (HCPs) deliver evidence-based services in ensuring the desired healthcare result is achieved