Knowledge and Utilization of Health Insurance following the Rollout of the State Contributory Health and Basic Healthcare Provision Fund in Kaduna State, Nigeria

The availability of information to the public plays a fundamental role in creating awareness, building trust and improving utilization of health insurance schemes. Knowledge of health insurance is often limited, and results in low utilization rates of services among vulnerable groups or those in informal sectors. This study examines the knowledge and utilization of health insurance schemes in Kaduna State, using z-test of difference of two proportions at 5% level of significance for 1944 respondents. Statistical analysis (chi-square tests and Z-test of proportions) using Stata 16.0 revealed that 86.1% of respondents have heard of the general term ‘Health Insurance”. Knowledge declined significantly for specific schemes (KADCHMA: 67.0% and BHCPF: 59.2%). The State Contributory Health Scheme (KADCHMA) shows the highest mean utilization of services at 1,167.08 enrollees, National Health Insurance at 458.23 enrollees, private health insurance at 219.90 enrollees, BHCPF 179.61 at enrollees and Tertiary institutions Social Insurance scheme at 0.33. Despite the successes recorded, less than half of the population (49.6%) understands the operationality of the schemes, 29.3% only heard of the schemes with no understanding of their functionality, and 9.8% only heard of the schemes indicating low knowledge. The average percentage of the catchment population covered under all the schemes is extremely low, averaging 15.97% per facility. Addressing these issues requires multi-stakeholders’ engagement to create awareness and mobilize citizens to understand and enrolled into the health insurance schemes.