Impact of User and Service Provider Related Variables on Utilisation of Tertiary Institution Social Health Insurance Programme (TISHIP) in the University of Uyo, Nigeria

Uduakobong Inyang1,3,5,6*, Enobong Gideon Asuquo 2,6, Chioma Dorothy Oleka4, Daniel Chukwudi Okeke3,5
1Department of Insurance, University of Uyo, Akwa Ibom State, Nigeria
2Department of Nursing and Midwifery, University of Limerick, Limerick, Ireland
3Department of Insurance and Risk Management, Enugu State University of Science & Technology, Enugu, Nigeria
4Department of Banking & Finance, Enugu State University of Science and Technology, Enugu, Nigeria
5Risk Management & Insurance Research Cluster, University of Uyo, Akwa Ibom State, Nigeria
6Research for Impact Cluster, University of Uyo, Akwa Ibom State, Nigeria
DOI – http://doi.org/10.37502/IJSMR.2023.6904

Abstract

This study examined the impact of user and service provider-related variables on utilization of tertiary institution social health insurance programme, TISHIP, in the University of Uyo, Nigeria. Cross-sectional data was collected with the use of a questionnaire from 400 full-time undergraduate students in the University of Uyo, Nigeria, to examine the effect of selected user-related and service provider-related variables on utilization of TISHIP. A logistic regression model was used in the analysis and the results were presented as marginal effects. The results showed that students’ awareness of TISHIP significantly increased utilization of TISHIP while poor access to healthcare facility and non-availability of medical consumables significantly reduced utilization of the scheme. These findings suggest the significance of continuous orientation of programme’s participants, improved access to service provider and adequacy of relevant consumables to the success of a targeted social support programme. Overall, the study raises important recommendations to inform practice and ensure the effectiveness of TISHIP.

Keywords: Health risk, social health Insurance, Cross-sectional study, Logistic regression, Nigeria.

References

  • Adibe, M. O., Udeogaranya, P. O., & Ubaka, C. M. (2011). Awareness of National Health Insurance Scheme (NHIS) activities among employees of a Nigerian university. International Journal of Drug Development and Research, 3(4), 0-0.
  • Ahmed, A. K., & Agbana, B. E. (2015). Assessment of awareness, perception and utilization of health services among patients attending clinic at the Muslim Ummah Hospital, Kisi, South-west, Nigeria. Editorial Board, 24(1).
  • Alderman, L. (2014). Purposeful program theory: Effective use of theories of change and logic models [Book Review]. Evaluation Journal of Australasia, 14(1), 46-47.
  • Alhassan, R. K., Nketiah-Amponsah, E., & Arhinful, D. K. (2016). A review of the National Health Insurance Scheme in Ghana: what are the sustainability threats and prospects?. PloS one, 11(11), e0165151.
  • Andersen, R M. 1968. Behavioral Model of Families’ Use of Health Services, Research Series no. 25. Chicago: Center for Health Administration Studies, University of Chicago.
  • Anetoh, M. U., Jibuaku, C. H., Nduka, S. O., & Uzodinma, S. U. (2017). Knowledge and Implementation of Tertiary Institutions’ Social Health Insurance Programme (TISHIP) in Nigeria: a case study of Nnamdi Azikiwe University, Awka. Pan African Medical Journal, 28(1).
  • Aniwada, E. C., Ndu, A. C., Okoye, C. J., Okoye, P. C., Okpala, A. C., & Okpala, C. V. (2019). Utilization of tertiary institutions social health insurance programme (TISHIP) among undergraduate students in Enugu State. Nigerian Journal of Medicine, 28(4), 413-422.
  • Awoyemi, T. T., Obayelu, O. A., & Opaluwa, H. I. (2011). Effect of distance on utilization of health care services in rural Kogi State, Nigeria. Journal of human Ecology, 35(1), 1-9.
  • Comfort, A. B., Peterson, L. A., & Hatt, L. E. (2013). Effect of health insurance on the use and provision of maternal health services and maternal and neonatal health outcomes: a systematic review. Journal of health, population, and nutrition, 31(4 Suppl 2), S81.
  • Gabriel, A., & Oluseye, I. (2017). Health Insurance and Health Care Demand Pattern among Staff and Students of Selected Universities in Southwestern Nigeria. British Journal of Education, Society & Behavioural Science, 20(2) , 1-13.
  • Heston, T. F., & King, J. M. (2017). Predictive power of statistical significance. World journal of methodology, 7(4), 112.
  • James, T. G., Sullivan, M. K., Dumeny, L., Lindsey, K., Cheong, J., & Nicolette, G. (2020). Health insurance literacy and health service utilization among college students. Journal of American College Health, 68(2), 200-206.
  • Johnson, V. E. (2013). Revised standards for statistical evidence. Proceedings of the National Academy of Sciences, 110(48), 19313-19317.
  • Kader, H., Hassan, A., El Gaafary, M., & Kama, b. (2015). Awareness and Utilization of Health Services Provided to Ain Shams University Students. The Egyptian Journal of Community Medicine, 34(4), 17-33.
  • Meng, Q., Fang, H., Liu, X., Yuan, B., & Xu, J. (2015). Consolidating the social health insurance schemes in China: towards an equitable and efficient health system. The Lancet, 386(10002), 1484-1492.
  • Mohammed, S., Sambo, M. N., & Dong, H. (2011). Understanding client satisfaction with a health insurance scheme in Nigeria: factors and enrollees experiences. Health research policy and systems, 9(1), 1-8.
  • Mohammed, S., Souares, A., Bermejo, J. L., Sauerborn, R., & Dong, H. (2014). Performance evaluation of a health insurance in Nigeria using optimal resource use: health care providers perspectives. BMC Health Services Research, 14(1), 1-12.
  • Nunes, M., Walker, J. R., Syed, T., De Jong, M., Stewart, D. W., Provencher, M. D., & Furer, P. (2014). A national survey of student extended health insurance programs in postsecondary institutions in Canada: Limited support for students with mental health problems. Canadian Psychology/Psychologie canadienne, 55(2), 101.
  • Odeyemi, I., & Nixon, J. (2013). Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis. International journal for equity in health, 12(1), 1-18.
  • Odeyemi, I. A. (2014). Community-based health insurance programmes and the national health insurance scheme of Nigeria: challenges to uptake and integration. International journal for equity in health, 13(1), 1-13.
  • Onoka, C. A., Onwujekwe, O. E., Uzochukwu, B. S., & Ezumah, N. N. (2013). Promoting universal financial protection: constraints and enabling factors in scaling-up coverage with social health insurance in Nigeria. Health research policy and systems, 11(1), 1-10.
  • Reich, M. R., Harris, J., Ikegami, N., Maeda, A., Cashin, C., Araujo, E. C. & Evans, T. G. (2016). Moving towards universal health coverage: lessons from 11 country studies. The Lancet, 387(10020), 811-816.
  • Shagaya, Y. J. (2015). Assessment of student’s satisfaction and quality of patient care under the Nigerian Tertiary Institutions Social Health Insurance Programme (TISHIP). Assessment, 7(6).
  • Sood, N., & Wagner, Z. (2018). Social health insurance for the poor: lessons from a health insurance programme in Karnataka, India. BMJ global health, 3(1), 582.
  • Spaan, E., Mathijssen, J., Tromp, N., McBain, F., Have, A. T., & Baltussen, R. (2012). The impact of health insurance in Africa and Asia: a systematic review. Bulletin of the World Health Organization, 90, 685-692.
  • Sperandei, S. (2014). Understanding logistic regression analysis. Biochemia medica, 24(1), 12-18.
  • Sule, A. G., Akorede, S. N., Suleiman, M. A., Aiyebelehin, A. O., Sharu, N. A., Dila, H. K., & AKOREDE, S. N. (2021). Assessment of awareness of tertiary institution social health insurance programme (tiship) among students of tertiary institutions in Kaduna state, Nigeria. Global Journal of Health Related Researches, 3(2), 203-211.
  • Sule, H. H. (2020). Challenges of Implementing Tertiary Institution Social Health Insurance Programme: Empirical Evidence From Southwest Nigeria. Canadian Social Science, 16(6), 21-31.
  • Tavakol, M., & Dennick, R. (2011). Making sense of Cronbach’s alpha. International journal of medical education, 2, 53.
  • Tey, N. P., & Lai, S. L. (2013). Correlates of and barriers to the utilization of health services for delivery in South Asia and Sub-Saharan Africa. The Scientific World Journal, 2013.
  • Titus, O. B., Adebisola, O. A., & Adeniji, A. O. (2015). Health-care access and utilization among rural households in Nigeria. Journal of development and agricultural economics, 7(5), 195-203.
  • You, X., & Kobayashi, Y. (2011). Determinants of out-of-pocket health expenditure in China. Applied health economics and health policy, 9(1), 39-49.
  • Vaske, J. J., Beaman, J., & Sponarski, C. C. (2017). Rethinking internal consistency in Cronbach’s alpha. Leisure sciences, 39(2), 163-173.
  • Vembe T., Okafor I. & Innocent N (2019). Awareness and patronage of the tertiary institutions social health insurance programme (TISHIP) among students of tertiary institutions in Abuja, Nigeria. Global Journal of Applied, Management and Social Sciences, 17, 32-37.
  • Wagstaff, A. (2010). Social health insurance reexamined. Health economics, 19(5), 503-517.
  • Williams, R. (2012). Using the margins command to estimate and interpret adjusted predictions and marginal effects. The Stata Journal, 12(2), 308-331.