Uptake of the Edo State Health Insurance Scheme by Civil Servants in Benin City, Nigeria

Abstract

Background: Financial constraints often limit the delivery of quality health services. Universal Health Coverage (UHC) ensures that all individuals can access essential health services without financial hardship. To achieve UHC for its citizens, the Edo State Government introduced the Edo State Health Insurance Scheme (EDOHIS) in 2019 and made it compulsory for state civil servants. This study assessed the uptake of EDOHIS among state civil servants in Benin City.

Methods: A descriptive cross-sectional study was conducted among 520 state civil servants in Benin City who were selected using a two-stage cluster sampling technique from 12 MDAs. Data was collected by a self-administered online questionnaire and analyzed with IBM SPSS 25.0. Ethical approval was obtained from the Ethics and Research Committee at the University of Benin Teaching Hospital.

Results: The mean age of respondents was 43.4±8.7 years, with 477 (91.9%) enrolled in EDOHIS. Non-enrollees cited reasons such as narrow policy options (47.6%) and infrequent illness (45.2%). Most enrollees (81.8%) had used the scheme, with 73.8% expressing satisfaction. Those who had not accessed care mentioned reasons like inadequate coverage (41.4%), distance to the allocated facility (34.5%), and not being sick (31.0%). The determinants of enrolment were being female (AOR=0.386, 95% CI=0.187–0.799, p=0.010); Christian (AOR=3.443, 95% CI=1.167–10.158, p=0.025) and married (AOR = 4.100, 95% CI=2.022–8.315, p=0.001).

Conclusion: There was a high uptake of EDOHIS among civil servants, with most enrollees satisfied with the services. More insurance policy options should be added to the scheme to increase its coverage.