Promoting Universal Health Coverage as Health Security: Civil Servants’ Knowledge, Attitude, and Utilization of the National Health Insurance Scheme in Ebonyi State, Nigeria

The out-of-pocket health expenses play an important role in health financing but do not promote equitable access to quality health care thus the need for financial risk protection from ill health. This is the rationale for National Health Insurance Scheme (NHIS) in Nigeria. This study determined the knowledge, attitude and utilization of the National Health Insurance Scheme in Ebonyi state Nigeria. Data obtained from randomly selected civil servants in the public sector using a self-administered questionnaire was subjected to descriptive analysis, and hypotheses was tested at p  < .05. All analysis was done using SPSS version 20. Overall, majority 363 (91.9%) of the respondents had a good knowledge of the scheme, a majority 375 (94.9%) had good attitude toward the scheme but only 96 (24.3%) registered with the scheme. The hindrances to use of NHIS were not knowing where to register 243 (63.1%), not interested in NHIS 155 (40.3%), delay at registration site 187 (48.6%), delay in getting NHIS card 163 (42.3%), unfriendly attitude of NHIS staff 160 (41.6%), and none availability of expected services 147 (38.2%). Knowledge was significant with age, sex, marital status, level of education and ministry ( p  < .05); attitude was not significant with the socio-demographic variables ( p  > .05), while utilization was significant with age, marital status and ministry ( p  < .05). Conclusively civil servants in Ebonyi state had a good knowledge and attitude toward the scheme but utilization was low thus more emphasis should be made through trainings and regular seminars on the benefits of enrollment to health insurance scheme to prompt high utilization of the scheme.