Knowledge of Social Health Insurance programs among artisans in Rivers State, Nigeria

Abstract

Background/Objectives: The Social Health Insurance Scheme (SHIS), administered under Nigeria's National Health Insurance Scheme (NHIS) is designed to distribute the financial risk of healthcare costs across a large group of individuals. By pooling these risks, SHIS allows for the payment of a premium based on the average cost of healthcare for the group, thereby making healthcare services more affordable. This mechanism is particularly relevant for artisans and others in the informal sector, who often face significant barriers to accessing affordable healthcare. This study aims to assess the level of knowledge about SHIS among artisans in Rivers State, Nigeria. The findings are intended to identify strategies that can expand health insurance services to this group, thereby enhancing their access to affordable healthcare. Design/Methods: The research employed a cross-sectional study design involving 598 artisans selected through a systematic random sampling technique. The target population included skilled workers such as bricklayers, carpenters, electricians, hairstylists and tailors. Data were collected using an interviewer-administered semi-structured questionnaire and analyzed using IBM SPSS version 22. Statistical methods, including Chi-square and binary logistic regression were used to assess associations between variables, with a significance level set at p < 0.05. Results: The study found that the majority of artisans were self-employed, with most having attained secondary education. Income levels were predominantly in the lower to middle brackets, with a significant proportion of artisans categorized as "poor" or "middle class" in terms of wealth. Knowledge about SHIS was generally low, as indicated by mean scores on knowledge-related statements ranging from 1.75 to 2.55 on a 4-point Likert scale. This suggests a widespread lack of awareness or uncertainty about SHIS. Conclusion: The study concludes that knowledge of SHIS among artisans in Rivers State remains significantly low, limiting their ability to benefit from the scheme. Addressing the barriers identified and implementing targeted strategies could enhance enrolment and improve healthcare access for this critical segment of the population.