Assessing the Relationship Between Health Insurance Protection and Availability of Quality Healthcare

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Assessing the Relationship Between Health Insurance Protection and Availability of Quality Healthcare

CHAPTER ONE

INTRODUCTION

1.1 Background to the Study

Access to quality healthcare is a fundamental human right and a key determinant of population health and socioeconomic development. However, in many low- and middle-income countries, access to healthcare services is constrained by financial, geographic, and systemic barriers. One of the most important mechanisms for reducing these barriers is health insurance coverage, which protects individuals from catastrophic health expenditures and improves access to essential health services (World Health Organization [WHO], 2022).

Health insurance plays a critical role in facilitating timely use of preventive, curative, and rehabilitative health services. It reduces out-of-pocket payments, encourages early health-seeking behaviour, and improves continuity of care (Saksena et al., 2011). Studies have shown that insured individuals are more likely to utilize healthcare services, receive better quality care, and experience improved health outcomes compared to the uninsured (Cutler & Zeckhauser, 2004).

Quality healthcare, on the other hand, is defined not only by access but also by effectiveness, safety, timeliness, efficiency, and patient-centeredness (Institute of Medicine [IOM], 2001). Even when services are available, lack of financial protection may prevent individuals from accessing high-quality providers or completing recommended treatments. Thus, health insurance coverage and access to quality healthcare are closely interconnected.

In Nigeria and many developing countries, health insurance coverage remains low, and a large proportion of healthcare financing is still based on out-of-pocket payments. This has contributed to inequities in healthcare access and quality, particularly among vulnerable populations (Onoka et al., 2014). Understanding the relationship between health insurance coverage and access to quality healthcare is therefore essential for improving health system performance and achieving universal health coverage (UHC).

This study explores the relationships between health insurance coverage and access to quality healthcare, with the aim of generating evidence that can inform policy and practice.

1.2 Statement of the Problem

Despite global efforts to promote universal health coverage, many individuals still face significant barriers to accessing quality healthcare. A major challenge is the lack of adequate health insurance coverage, which exposes households to high out-of-pocket payments and discourages timely utilization of healthcare services (WHO, 2022).

In settings where insurance coverage is limited, people often delay seeking care, rely on informal providers, or forego treatment altogether due to cost. Even when care is accessed, financial constraints may result in receiving lower-quality services or incomplete treatment (Saksena et al., 2011).

In Nigeria, the National Health Insurance Authority (NHIA) has made efforts to expand coverage, but enrollment remains uneven and largely restricted to formal sector workers. This leaves a large segment of the population without financial protection and with limited access to quality healthcare services (Onoka et al., 2014).

The problem this study seeks to address is the inadequate understanding of how health insurance coverage influences access to quality healthcare. Without clear empirical evidence, health policies may fail to effectively target barriers to quality service utilization.

1.3 Objectives of the Study

The main objective of this study is to explore the relationship between health insurance coverage and access to quality healthcare.

The specific objectives are to:

Examine the level of health insurance coverage among the study population.

Assess access to quality healthcare services among insured and uninsured individuals.

Determine the relationship between health insurance coverage and healthcare utilization.

Identify challenges affecting access to quality healthcare despite insurance coverage.

1.4 Research Questions

What is the level of health insurance coverage among the population?

How does access to quality healthcare differ between insured and uninsured individuals?

Is there a significant relationship between health insurance coverage and healthcare utilization?

What factors limit access to quality healthcare even among insured persons?

1.5 Significance of the Study

This study will be useful to policymakers, healthcare providers, insurance administrators, and researchers. It will provide evidence on how insurance coverage affects access to quality healthcare and help guide reforms aimed at achieving universal health coverage. The findings can support better design of insurance schemes and service delivery improvements (Cutler & Zeckhauser, 2004).

1.6 Scope of the Study

The study focuses on examining the relationship between health insurance coverage and access to quality healthcare services among adults within the selected study area. It considers insurance status, service utilization, and perceived quality of care.

1.7 Operational Definition of Terms

Health Insurance Coverage: Financial protection against health-related costs through enrollment in an insurance scheme.

Access to Quality Healthcare: The ability to obtain timely, safe, effective, and patient-centered healthcare services.

Universal Health Coverage (UHC): Ensuring all people have access to needed health services without financial hardship.

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