Journal of Community Medicine and Primary Health Care

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Preferred approach to performance improvement among stakeholders in the health insurance industry in Southwest Region of Nigeria: Implications for Universal Health Coverage

D.A. Adewole, S Bello, S.A. Adebowale


Background: Population coverage of the National Health Insurance Scheme (NHIS) of Nigeria is low. This study aimed to assess the capacity gaps of personnel in the health insurance industry in southwest Nigeria as well determined the approach to improvement.

Methods: This was a cross-sectional survey conducted in the health insurance industry in southwest Nigeria. Survey tool adapted was the World Health Organization adopted Hennessy-Hicks Training Needs Analysis Questionnaire with a set of 30 tasks which are important to the job performance of personnel in the health insurance industry. From the register made available by stakeholders, there were a total of 275 personnel in the industry in the zone. A total population of all available personnel in all the organizations were recruited into the study. Data analysis was done using the guideline provided in the Hennessy-Hicks Training Needs Analysis Questionnaire.

Results: Only 32 (13.7%) reported having a training background in health-related degrees, 119 (50.9%) had work-related (actuarial science) training while 148 (63.3%) has had a form of on-the-job actuarial science and related training. The training course approach was generally preferred to organisational change in all items.

Conclusion: This study showed that there were gaps in the capacity of personnel in the health insurance industry. Training course was the preferred approach to addressing these. While not neglecting organizational change, stakeholders in Nigeria and in similar settings are advised to pay more attention to personnel training to improve performance.

Keywords: Performance; Improvement; Health insurance; Universal health coverage; Training

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