eprintid: 18672
rev_number: 27
eprint_status: archive
userid: 1589
dir: disk0/00/01/86/72
datestamp: 2015-05-27 09:06:22
lastmod: 2022-07-18 01:23:24
status_changed: 2015-05-27 09:06:22
type: article
metadata_visibility: show
creators_name: Mohammed, Shafiu
creators_name: Bermejo, Justo Lorenzo
creators_name: Souares, Aurélia
creators_name: Sauerborn, Rainer
creators_name: Dong, Hengjin
title: Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users’ perspectives
subjects: 300
subjects: 610
divisions: 911800
divisions: 912800
abstract: Background: Responsiveness of health care services in low and middle income countries has been given little attention. Despite being introduced over a decade ago in many developing countries, national health insurance schemes have yet to be evaluated in terms of responsiveness of health care services. Although this responsiveness has been evaluated in many developed countries, it has rarely been done in developing countries. The concept of responsiveness is multi-dimensional and can be measured across various domains including prompt attention, dignity, communication, autonomy, choice of provider, quality of facilities, confidentiality and access to family support. This study examines the insured users’ perspectives of their health care services’ responsiveness. Methods: This retrospective, cross-sectional survey took place between October 2010 and March 2011. The study used a modified out-patient questionnaire from a responsiveness survey designed by the World Health Organization (WHO). Seven hundred and ninety six (796) enrolees, insured for more than one year in Kaduna State-Nigeria, were interviewed. Generalized ordered logistic regression was used to identify factors that influenced the users’ perspectives on responsiveness to health services and quantify their effects. Results: Communication (55.4%), dignity (54.1%), and quality of facilities (52.0%) were rated as “extremely important” responsiveness domains. Users were particularly contented with quality of facilities (42.8%), dignity (42.3%), and choice of provider (40.7%). Enrolees indicated lower contentment on all other domains. Type of facility, gender, referral, duration of enrolment, educational status, income level, and type of marital status were most related with responsiveness domains. Conclusions: Assessing the responsiveness of health care services within the NHIS is valuable in investigating the scheme’s implementation. The domains of autonomy, communication and prompt attention were identified as priority areas for action to improve this responsiveness. For the Nigerian context, we suggest that health care providers in the NHIS should pay attention to these domains, and the associated characteristics of users, when delivering health care services to their clients. Policy makers, and the insurance regulatory agency, should consider the reform strategies of monitoring and quality assurance which focus on the domains of responsiveness to lessen the gap between users’ expectations and their experiences with health services.  
date: 2013
publisher: BioMed Central
id_scheme: DOI
ppn_swb: 1657049035
own_urn: urn:nbn:de:bsz:16-heidok-186722
language: eng
bibsort: MOHAMMEDSHASSESSINGR2013
full_text_status: public
publication: BMC health services research
volume: 13
number: 502
place_of_pub: London
pagerange: 1-13
issn: 1472-6963
citation:   Mohammed, Shafiu ; Bermejo, Justo Lorenzo ; Souares, Aurélia ; Sauerborn, Rainer ; Dong, Hengjin  (2013) Assessing responsiveness of health care services within a health insurance scheme in Nigeria: users’ perspectives.  BMC health services research, 13 (502).  pp. 1-13.  ISSN 1472-6963     
document_url: https://archiv.ub.uni-heidelberg.de/volltextserver/18672/1/12913_2013_Article_2924.pdf