Perception and utilization of national health insurance authority (NHIA) among staff of the Federal Ministry of Agriculture and Food Security in Akwa Ibom State, Nigeria

Abstract

The study examined the perception and utilization of the National Health Insurance Authority (NHIA) among staff of the Federal Ministry of Agriculture and Food Security in Akwa Ibom State, Nigeria. Specifically, it described respondents’ socio-economic characteristics, assessed their perception of NHIA services, determined their level of utilization, identified influencing factors, and examined the relationship between perception and utilization. A multistage sampling technique was used to select 150 respondents across relevant departments. Data were collected using a validated questionnaire and analyzed using descriptive statistics, Pearson correlation, and multiple regression. Results showed that most respondents were male (58.7%), aged 40–49 years (34.0%), married (65.3%), with HND/B.Sc qualifications (46.0%), and earned ₦101,000–₦150,000 monthly (37.3%). About 67.3% had a positive perception of NHIA, especially regarding reduced medical expenses (𝑥̅ = 3.31), though out-of-pocket payments remained common. Utilization was moderate, with 40.0% reporting high usage, mainly for outpatient and curative services (e.g., hospital visits, 𝑥̅ = 3.28; prescribed drugs, 𝑥̅ = 3.13), while maternity (𝑥̅ = 2.42) and emergency care (𝑥̅ = 2.65) were less utilized. A strong positive correlation (r = 0.621, p < 0.01) was observed between perception and utilization. Regression results revealed that age, educational qualification, job grade level, and income significantly influenced NHIA utilization, explaining 53.2% of the variance (R² = 0.532). The study concludes that while staff had favorable perceptions of NHIA, service utilization was shaped by socio-economic factors. It recommends improved awareness and streamlined service delivery to enhance access and usage among public sector employees.