Evaluation of the National Health Insurance Scheme among the Vulnerable in Lokoja, Nigeria

ABSTRACT The study evaluates the effectiveness of the National Health Insurance Scheme among pregnant women using the case of the Lokoja area of Nigeria. Primary data were obtained with the use of a mixed (qualitative and quantitative) method design and analyzed using an exploratory sequential design analysis of inductive approach and descriptive for the qualitative and quantitative respectively. The study also employed the use of semi-structured interviews and an online survey questionnaire for collation of data as well as the Statistical Packages for Social Sciences for the correlation and regression analysis of the quantitative data. The findings revealed that the majority of about 50% of citizens rarely pay their tax, thus affecting the outcome of NHIS services where about 36% (highest Score) of respondents indicated the ineffectiveness in NHIS services towards pregnant women. Moreover, the interviewed NHIS officials also indicated challenges faced in providing quality medical service delivery due to inadequate funds from the government. The study also revealed low-income levels of which the majority earn between the value of 50, 000 naira and 100, 000 naira as well as a majority of about 70% being self–employed, both serving as a drive in the frequency of tax payment by citizens. The hypothesis test for the study revealed that there is an association between inadequate tax funds and the ineffectiveness of the National Health Insurance scheme towards pregnant women in Lokoja with a value of 0.247 (p-value 0.027 < 0.05) at 5% level of significance. KEY WORDS: NHIS, Pregnant women, Lokoja, Nigeria, Tax funds, Income, Employment, Ineffectiveness, Inadequate