Effectiveness of the National Health Insurance Scheme (NHIS) in Improving Access to Maternal Healthcare among Federal Civil Servants in Selected Institutions in Kogi State, Nigeria

This study examines the effectiveness of the National Health Insurance Scheme (NHIS) in improving maternal healthcare access among federal civil servants in three selected federal institutions in Kogi State, Nigeria. Anchored in the Health Belief Model and Andersen’s Behavioural Model of Health Services Utilisation, the study adopted a concurrent mixed-method design combining a structured questionnaire administered to 351 respondents with in-depth interviews conducted with 20 female civil servants and three healthcare providers in NHIS-accredited facilities. Quantitative data were analysed using descriptive statistics, Pearson Product Moment Correlation (PPMC), and regression analysis, while qualitative data were subjected to thematic analysis. Findings revealed a high level of NHIS awareness among respondents and a moderate-to-high improvement in access to maternal healthcare services. However, significant challenges persisted, including incomplete coverage of certain maternal health services, administrative and bureaucratic delays at the point of care, and an inadequate number of NHIS-accredited health facilities in the state. All three null hypotheses were rejected at p < 0.05, confirming statistically significant relationships between NHIS enrolment, awareness, and utilisation of maternal healthcare services. The study recommends expanded benefit packages, streamlined administrative processes, accelerated accreditation of health facilities, and sustained targeted awareness campaigns as priority interventions for improving maternal health outcomes under the NHIS.

Keywords: National Health Insurance Scheme, Maternal Healthcare, Civil Servants, Utilisation.