Ibadan Journal of the Social Sciences
Volume 22, No. 1, 2024
DOI: 10.36108/ijss/4202.22.0111
Navigating Wellness: Influence of Health Insurance Adoption on Health-Seeking Behaviour of Employees in Private Organizations in Enugu State, Nigeria
Promise N. Starris-Onyema 1 and Ezebunwa E. Nwokocha 2
1 IVAN Research Institute, College of Medicine University of Nigeria, Enugu Campus, Nigeria
2Department of Sociology, University of Ibadan, Nigeria
Abstract
Healthcare access and utilization are fundamental components of well-being, and the adoption of health insurance scheme (HIS) in private organizations has become a prominent strategy to enhance employees’ access to healthcare services. This Study examines the relationship between the adoption of HIS and the health-seeking behaviour of employees in private organizations in Enugu State, Nigeria. Structural Functionalism and the Health Belief Model were adopted as framework. A mixed-methods approach, combining surveys and interviews, was utilized to gather both quantitative and qualitative data. A sample of 457 respondents was drawn using Yamane’s (1967) formula. A multi-stage sampling technique was used to administer semi-structured questionnaire to employees in manufacturing (369) and service (88) industries. Twenty-four in-depth interviews were conducted among employees. Sixteen key informant interviews were conducted with 8 management staff of private organizations, 4 healthcare providers from NHIS accredited hospitals, 2 health maintenance organisation managers, and 2 NHIS executive officers to elicit information on adoption of HIS and health-seeking behaviour of employees. Quantitative data were analysed using descriptive statistics and Logistic Regression at p≤0.05, while qualitative data were content-analysed. Respondents’ age was 38±2.4 years; 77.4% had tertiary education and 70.8% were married. Influence of HIS on health-seeking behaviour was significantly associated with female gender (OR = 1.96), tertiary education (OR = 7.27), senior staff position (OR = 1.57), and earning a monthly income of N100, 000 or more (OR = 4.04). Employers’ challenges in the adoption of HIS were payment of premiums, complex bureaucratic structure of the system, and inability to access certain hospitals due to their chosen HIS plan. Stakeholders should therefore increase awareness among private employers about the benefits of HIS and customise plans to suit the peculiarity of private sector employers to reduce their out-of-pocket health expenditure.
Keywords: Health insurance scheme, employee access to healthcare, out-of-pocket health expenditure