A qualitative survey of pre-payment scheme for healthcare services in a rural Nigerian community

Prepayment method for financing health care is one of the means to achieving the desired universal health coverage. However, expanding health insurance to cover the larger informal sector of the population in Nigeria is a persistent challenge especially in the rural areas. This study was carried out to assess the perception of health insurance scheme among rural dwellers in southwest Nigeria. Qualitative data was obtained with the aid of a focus group discussion guide. The FGD questions were framed along familiar themes common to prepayment methods as found in health insurance schemes. A total of six FGD sessions were conducted. Each of the FGD sessions consisted of between 8 – 12 participants. Two FGD sessions, consisting of separate male and female homogeneous groups were conducted in each of the three wards selected for the study. One FGD session lasted between one and a half to two hours and was audio-recorded. Qualitative data were analyzed manually engaging predetermined as well as emerging themes. Awareness about the health insurance scheme was quite low among study participants. Knowledge of the few who had ever heard about it was inadequate. Respondents generally had a positive attitude towards prepayment schemes and willingness to participate in it was high but were skeptical about its sustainability. Strategies to improve awareness about health insurance and its benefit packages among potential beneficiaries are desirable. Keywords: Prepayment scheme, Health insurance, Informal sector, Rural dwellers