National health insurance scheme: perceived factors influencing enrolment and health-seeking behaviour among employees of federal government establishments in Ebonyi State, Nigeria

The National Health Insurance Scheme has improved enrolment and health-seeking behaviour among Nigerians, especially federal government employees. Available evidence showed that most of the 5% of the Nigerian population so far covered by the scheme are federal employees, leaving state and local government employees, private sector employees, and the unemployed largely uncovered.

This descriptive study investigated some factors encouraging enrolment and health-seeking behaviour among federal government employees in Nigeria. Twenty-four participants were purposively selected from six federal government establishments in Ebonyi State. Data were collected using in-depth interviews and analysed manually using themes and quotes.

Findings revealed that subsidisation of healthcare costs, perceived benefits, compulsory enrolment for federal employees, easy access and affordable healthcare, financial protection, and satisfactory services were some of the factors that encouraged enrolment and health-seeking behaviour among federal employees. However, the study found that some employees were not satisfied with services received at the National Health Insurance Scheme-designated clinics.

There is a need for improved services by healthcare personnel and facilities for increased utilisation of the scheme. Social workers should advocate for quality and satisfactory services to the enrollees and create awareness of the benefits of the scheme to encourage more enrolment and utilisation.