Toward Universal Health Coverage: What Socioeconomic and Clinical Factors Influence Health Insurance Coverage and Restrictions in Access to Viral Hepatitis Services in Nasarawa State, Nigeria?

Victor Abiola Adepoju (), Donald C. Udah, Chinonye Alioha Ezenwa, Jamiu Ganiyu, Sumaiya Muhammad Lawal, James Ambo Haruna, Qorinah Estiningtyas Sakilah Adnani and Adamu Alhassan Ibrahim
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Victor Abiola Adepoju: Department of HIV and Infectious Diseases, Jhpiego Nigeria, Affiliate of Johns Hopkins University, Abuja 900911, Nigeria
Donald C. Udah: JSI Research & Training Institute Inc. (JSI), Abuja 900911, Nigeria
Chinonye Alioha Ezenwa: Department of Strategic Information, Jhpiego Nigeria, Affiliate of Johns Hopkins University, Abuja 900911, Nigeria
Jamiu Ganiyu: National AIDS/STI and Viral Hepatitis Control Program, Federal Ministry of Health, Abuja 900911, Nigeria
Sumaiya Muhammad Lawal: General Hospital Akwanga, Akwanga 960101, Nasarawa State, Nigeria
James Ambo Haruna: Our Ladies of Apostles Hospital, Akwanga 960101, Nasarawa State, Nigeria
Qorinah Estiningtyas Sakilah Adnani: Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, West Java, Indonesia
Adamu Alhassan Ibrahim: Director of Public Health Services, Nasarawa State Ministry of Health, Lafia 950101, Nasarawa State, Nigeria

IJERPH, 2024, vol. 21, issue 10, 1-13

Abstract: Background: Viral hepatitis B and C (HBV and HCV) pose significant public health concern in Nigeria, where access to healthcare and treatment affordability are limited. This study investigated sociodemographic and clinical predictors of health insurance coverage and access to care among patients with HBV and HCV in Nasarawa State, Nigeria. Methods: A cross-sectional facility-based study was conducted at two secondary hospitals in Nasarawa State, Nigeria. Participants included patients diagnosed with HBV, HCV, or both who were ≥18 years old. Data were collected using a structured questionnaire covering sociodemographic and clinical information, health insurance details, and economic impact. Binary logistic regression was used to analyze the relationship between sociodemographic/clinical factors and health insurance status. Results: Out of 303 participants, 68% had health insurance, which mostly covered hepatitis screening and vaccination. Significant predictors of health insurance coverage included being aged 36–40 years (adjusted odds ratio [aOR]: 11.01, 95% confidence interval [CI]: 2.38–50.89, p = 0.002), having post-secondary education (aOR: 25.2, 95% CI: 9.67–65.68, p < 0.001), being employed (aOR: 27.83, 95% CI: 8.85–87.58, p < 0.001), and being HIV-positive (aOR: 4.06, 95% CI: 1.55–10.61, p = 0.004). Nearly all those insured (99%) faced restrictions in insurance coverage for viral hepatitis services. Conclusions: This study reveals that while health insurance coverage is relatively high among viral hepatitis patients in Nasarawa State, significant restrictions hinder access to comprehensive services, especially for vulnerable groups like younger adults, the unemployed, and PLHIV. Key factors influencing coverage include age, education, employment, and HIV status. Expanding benefit packages to include viral hepatitis diagnosis and treatment, raising awareness about viral hepatitis as part of insurance strategy, improving access for underserved populations, and integrating hepatitis services into existing HIV programs with strong policy implementation monitoring frameworks are crucial to advancing universal health coverage and meeting the WHO’s 2030 elimination goals.

Keywords: health insurance; Nigeria; universal health coverage; sociodemographic predictors; viral hepatitis B and C (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2024
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