Assessment of the Impact of Health Maintenance Organizations on Access, Utilization and Quality of Service among National Health Insurance Authority Enrollees in Kano, Kano State Nigeria

Efforts by government in Nigeria in the past to provide effective ways of accessing quality and affordable healthcare service has always been contentious with high cost of health care service delivery. The ineffective management of health care funds over the years was observed as key contributor to the rising cost of healthcare services. The need for the establishment of health maintenance organizations (HMOs) whose responsibility as purchasers, was to manage health care services with health facilities providers under the National Health Insurance Authority Scheme (NHIA). However, this research seeks to assess the impact of healthcare purchasers in Kano state Nigeria, as regards knowledge, utilization and satisfaction of enrollees, whose healthcare services they managed. The study utilized analysis of enrollees, HMOs and desk officers under the scheme. Quantitative and qualitative methods using interviewer administered questionnaire and Key stakeholders’ interview were employed. Data were recorded in Microsoft Excel 2010 and analysed using SPSS version 23.0. NVIVO version 12 with verbatim transcription was used for thematic analysis of qualitative data. Chi-square was also used to test degree of association and logistic regression utilised to predict factors for the determinants. Results were presented as tables and charts. Statistical significance p-value