ABSTRACT

The’ study evaluated famers’ access to and utilization of National Health Insurance Scheme in Abia state, Nigeria. Specifically, the study described the socio-economic characteristics of farmers in the study area, examined the awareness of NHIS by the farmers, examined the level of access to NHIS by farmers, ascertained the level of utilization ofNHIS by farmers, assessed the effectiveness ofNHIS in meeting the health needs ofthe farmers, and identified the constraints of farmers in accessing and utilizing NHIS Scheme. Multistage sampling procedure was used in selecting 180 farmers. Data were collected using structured questionnaire and interview schedule. Descriptive statistics such as frequency distribution, mean scores, and percentages as well as inferential statistics such as multiple regression, Tobit regression analysis and Correlation analysis were used in testing the hypotheses. The results showed that the farmers had a mean age and a mean household size of 53 years and 7 persons respectively, while most (65.0%) were married. Furthermore, most (68.9%) of the farmers were aware of the National Health Insurance Scheme, and the major sources of information on NHIS services were from friends/ relation (95.7%), newspaper (64.4%), and extension agents (55.0%). The study further showed that the farmers had high level of access to NHIS (X = 2.13) and low level of utilization of NHIS (X = 1.94). NHIS scheme was shown to be effective in meeting the health needs ofthe farmer (X = 2.74), guaranteeing emergency response (X = 3.68), large area of coverage (X = 3.59), credibility (X = 3.59). The major constraints to access and utilization of NHIS in the study area were distance from house to the health center (X = 3.49), inability of the health personnel to attend to you promptly (X = 3.41), and low quality of drugs (X= 3.39). The result ofthe multiple regression analysis showed that the coefficient of age (- 93237.124), education (1613.220), farming experience (38490.305), and primary occupation (1.4938) were significantly related to access to NHIS, while the coefficient of age (-0.743), marital status (0.071), membership to cooperative (0.107), and primary occupation (0.006) significantly influenced the utilization of NHIS. The probit regression analysis showed that the coefficient for ease of registration (13.962), affordability of drugs (0.028), credibility ofscheme (-0.994) and authenticity ofscheme (-3.118) significantly influenced utilization of NHIS. The result of the correlation analysis showed that the coefficient of access to NHIS (0.227) was significantly related to its utilization by the farmers. The study recommended formation of cooperative societies by farmers, siting of more primary health care centres in the rural ■areas, attitudinal change ofNHIS staff, organization of awareness campaigns for rural farmers, and'improvement ofhealth infrastructure in the rural areas.