National Health Insurance Scheme: An Assessment of Service Quality and Clients’ Dissatisfaction

BACKGROUND: Health Insurance Scheme (NHIS), a medical package to start with a fraction of Nigerians at its inception, with the expectation of optimal services to all in the long The Nigerian government established National run. However, there are complaints and dissatisfaction of enrolees of the scheme. This study determined factors responsible for enrolees’ dissatisfaction of services in a general hospital within the federal capital territory, Abuja.METHOD: Three hundred enrolees of National Health Insurance Scheme at the Kubwa general hospital were enrolled. Semi structured questionnaires were used to obtain information on socio-demography, education, enrolee status, perception of the scheme and factors responsible for enrolees’ dissatisfaction. SPSS version 22 was used to analyse Data using percentage.RESULTS: Majority (66.3%) of the respondents were between 35 and 54years while 28.5% were below 35years and 11.8% (32) were above 54years with the male to female ratio was 1.03:1. Sixty percent (179) of the respondents had a minimum of tertiary education with just 1.8% having primary education. Most (69.9% and 79.6%) respondents were principal enrolees and public servants respectively. Seventy percent of the respondents have been enrolled in NHIS for more than 3years and had a good perspective of the scheme. However, 30% of the respondents were not satisfied with NHIS services with 8.6% and 15.4% describing the services as substandard and below expectations respectively. Half (50.7%) of the respondents would consider an alternative to NHIS suggesting their dissatisfaction. The major factors responsible for dissatisfaction were billing system, long waiting hours and staff attitude accounting for 46.9%, 59.4% and 7.8% respectively.CONCLUSION: This study revealed that the level of clients’ dissatisfaction with NHIS services is high despite their acceptance of the scheme with the major areas of concern being the billing system, waiting time and staff attitude. Therefore, it is necessary for the providers to look more into these areas as targets for service delivery improvement

Serum reference intervals of micronutrients, vitamins, and interleukins among healthy adults in South-Western Nigeria

Objectives: Clinical decision making depends mostly on appropriate application of numerical pathology reports from laboratory results, interpreted by comparison with reference intervals. We determined serum reference intervals of micronutrients, vitamins, and detectable interleukins among healthy adults in South-Western Nigeria. Design and methods: This prospective study used a priori selection approach in blood-donors. They were screened for conditions that could elicit cytokine production.Serum micronutrients were assayed using Atomic Absorption Spectrophotometry; interleukins and vitamins by high Performance Liquid Chromatography. The reference intervals (RIs) were estimated at 2.5th percentile and 97.5th percentile. Results: One hundred and eighteen (118) apparently healthy subjects, aged 18–56 years; 113 (95.8%) being 18–44years, and 5 (4.2%): 45–56 years; mostly males, 13 (11.02%) females, all Africans of Yoruba ethnicity.Estimated reference limits were: Zinc: 9.49–20.54 μmol/L, Selenium: 0.50–1.11 μmol/L, Copper: 13.86–27.97 μmol/L, Iron: 14.19–32.07 μmol/L, Manganese: 6.24–16.37 nmol/L; Magnesium: 0.78–1.62 mmol/L.Vitamins: A-1.08–2.39 μmol/L; D: 59.89–164.42 μmol/L; E: 7.13–19.45 μmol/L; K: 0.16–0.42 nmol/L; B1: 74.09–201.56 nmol/L; B6: 0.12–0.29 nmol/L; B12: 155.55–407.96 pmol/L; C: 47.74–112.99 μmol/L.Detected interleukins (IL-1 to IL-18): IL-1: 0.58–1.24 ng/L, IL-2: 0.09–0.18 ng/L, IL-3: 0.39–0.89 ng/L, IL-4: 0.27–0.58 ng/L, ….to IL-18: 0.74–1.56 ng/L. Conclusions: The RI derived from this study for serum micronutrient, vitamin and interleukin concentrations are the first published for our population. They are in general agreement with those published from other geographical climes but there are differences at the lower and upper limits of the RI. The study reinforces the importance of deriving RI for the population that a clinical laboratory will serve