Analysing the Determinants of Healthcare Insurance Uptake in Nigeria

The challenge of low health insurance coverage in Nigeria has persisted for decades, hindering access to healthcare, and impacting human capital development negatively. This is despite the diverse types of health insurance schemes co-existing in the country. The current study, therefore, sought to identify the potential factors driving the uptake of health insurance and its types (private and public health insurance) in Nigeria. To achieve the objective, the study assessed cross-sectional data across the 36 States in Nigeria (including the Federal Capital Territory -FCT) obtained from the 2018 Nigeria Demographic and Health Survey (DHS). Accordingly, this study highlighted stylised facts about health insurance and key socio-economic factors, while regression analysis was explored to determine the crucial factors motivating health insurance uptake in Nigeria. The analysis showed that the positive drivers of health insurance uptake (mainly private) include the financial inclusion rate and employment level. The study also observed that due to financial constraints, low-income groups might be less likely to enrol on health insurance than the middle-income and high-income groups. Education is found to have a statistically significant and negative effect on health insurance uptake in the country. On the other hand, health access problems and age of the household head did not have statistically significant effects on health insurance uptake. With the National Health Insurance Authority (NHIA) Act 2021 making health insurance mandatory, it is imperative for the Nigerian government to strengthen the identified positive drivers of health insurance uptake across the country.