EVALUATION OF THE IMPACT OF NATIONAL HEALTH INSURANCE AUTHORITY (NHIA) ON THE ACCESSIBILITY OF MEDICINE AT THE UNIVERSITY OF BENIN TEACHING HOSPITAL (UBTH)
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Abstract
Access to essential medicines is central to Universal Health Coverage, yet patients continue to face high out-of-pocket costs, frequent drug stock-outs and limited formularies. The National Health Insurance Authority (NHIA, formerly NHIS) aims to improve affordability and access, but its real-world impact on medicine accessibility at tertiary hospitals requires evaluation. Objectives General: To evaluate the impact of NHIA on accessibility to medicines at the University of Benin Teaching Hospital (UBTH).
Method: A cross-sectional, descriptive survey of NHIA-enrolled patients attending the General Patients Clinic (GPC) and Consultant Out-patients (COPD) NHIA pharmacy units at UBTH. A structured, self-administered questionnaire was completed by 311 patients (100% response rate). Data were coded and analysed in SPSS v21, using descriptive statistics and Chi-square tests;
significance set at p < 0.05. Results: 311 respondents (majority 41–60 years, 58.2% male) participated in the study. Overall,
accessibility and service efficiency under NHIA were rated moderate: respondents acknowledged improved affordability, but reported persistent problems with drug availability and the collection process. Major barriers were drug stock-outs, long waiting times and poor staff communication. Statistically significant associations were observed between medicine accessibility and age
(χ²=22.0, p=0.005), education (χ²=13.8, p=0.03), duration of NHIA enrolment (χ²=16.9, p=0.02) and awareness (χ²=6.00, p=0.05). Perceived NHIA efficiency was significantly associated with age (χ²=15.5, p=0.04). A cross-tabulation of barriers/recommendations versus efficiency showed no significant association (χ²=11.46, p=0.32). Conclusions: NHIA enrolment at UBTH provides measurable financial relief and improves affordability of medicines, but is constrained by operational challenges—chiefly inconsistent medicine supply, limited formulary coverage and administrative delays. Strengthening supplychain
management, expanding the NHIA drug list, digitalizing claims and pharmacy workflows, improving staffing and instituting routine beneficiary feedback are recommended to enhance medicine accessibility and service efficiency
Method: A cross-sectional, descriptive survey of NHIA-enrolled patients attending the General Patients Clinic (GPC) and Consultant Out-patients (COPD) NHIA pharmacy units at UBTH. A structured, self-administered questionnaire was completed by 311 patients (100% response rate). Data were coded and analysed in SPSS v21, using descriptive statistics and Chi-square tests;
significance set at p < 0.05. Results: 311 respondents (majority 41–60 years, 58.2% male) participated in the study. Overall,
accessibility and service efficiency under NHIA were rated moderate: respondents acknowledged improved affordability, but reported persistent problems with drug availability and the collection process. Major barriers were drug stock-outs, long waiting times and poor staff communication. Statistically significant associations were observed between medicine accessibility and age
(χ²=22.0, p=0.005), education (χ²=13.8, p=0.03), duration of NHIA enrolment (χ²=16.9, p=0.02) and awareness (χ²=6.00, p=0.05). Perceived NHIA efficiency was significantly associated with age (χ²=15.5, p=0.04). A cross-tabulation of barriers/recommendations versus efficiency showed no significant association (χ²=11.46, p=0.32). Conclusions: NHIA enrolment at UBTH provides measurable financial relief and improves affordability of medicines, but is constrained by operational challenges—chiefly inconsistent medicine supply, limited formulary coverage and administrative delays. Strengthening supplychain
management, expanding the NHIA drug list, digitalizing claims and pharmacy workflows, improving staffing and instituting routine beneficiary feedback are recommended to enhance medicine accessibility and service efficiency
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