Assessing the Impact of The National Health Insurance Scheme on Healthcare Access for Staff in South-East Nigeria’s Federal Tertiary Institutions

Abstract

Healthcare affordability and accessibility remain major challenges in Nigeria despite the introduction of the National Health Insurance Scheme (NHIS). This study assessed the impact of NHIS implementation on healthcare access for staff in three federal tertiary institutions in South-East Nigeria, University of Nigeria Nsukka, Alvan Ikoku Federal College of Education Owerri, and Federal Polytechnic Oko. A descriptive cross-sectional survey design was employed. The population comprised 3,450 academic and non-academic employees, from which a stratified random sample of 300 respondents was selected. Data from 270 valid questionnaires were analyzed using descriptive statistics, multiple regression, and analysis of variance (ANOVA) with SPSS version 26. Results showed that affordability, utilization, and timeliness significantly predicted healthcare access, jointly explaining 71 percent of the variance (Adjusted R² = 0.71, p < 0.05). Affordability had the strongest positive effect (β = 0.42, p < 0.001), while institutional differences were attributed to administrative efficiency. The study concludes that NHIS has improved healthcare access among tertiary-institution staff but remains limited by delays and weak coordination. It recommends digitalized claims processing, stronger monitoring systems, and staff sensitization to ensure equitable and timely healthcare delivery.