Service Utilization and Client Satisfaction with the Tertiary Institutions Social Health Insurance Programme (TISHIP) Among Undergraduate Students of Bayero University Kano, Nigeria
Abstract
Tertiary Institutions Social Health Insurance Programme was introduced to broaden access to quality, affordable health care for learners/domestic students in tertiary institutions in Nigeria. But there are ongoing challenges about service utilization and client satisfaction to the effectiveness of the programme. This research appraised the service utilization and satisfaction of TISHIP service among undergraduate students of Bayero University Kano from a perspective of Development Communication. A descriptive cross-sectional survey design was used with 420 students from undergraduate study selected using multi-stage sampling technique. In total 402 questionnaires were returned and analysed, corresponding to 95.7% return. A structured questionnaire was used to collect data and the Statistical Package for the Social Sciences version 29 was used to analyze the data. Data was summarized using descriptive statistics and Chi-square tests and binary logistic regression were used to test the factors associated with the utilization of services and client satisfaction at 5% level of significance. The results revealed that 84.1% of the respondents knew about TISHIP, but only 60.4% had sufficient knowledge about the benefits and services available in TISHIP. About 66.7% had used TISHIP services in the last 12 months, with the most common being outpatient consultations and pharmacy services. The satisfaction of the clients was generally 71.6%, with high satisfaction with attitude of healthcare providers (79.4%) and quality of consultation (76.1%), and lower satisfaction with waiting time (48.5%) and having access to essential medicines (54.2%). The findings of the chi-square analysis revealed that there were significant differences among the awareness, waiting time, provider attitude, drug availability, communication effectiveness, and TISHIP utilization (p < 0.05). Furthermore, logistic regression analysis identified effective communication (AOR = 2.89; 95% CI = 1.74–4.79), awareness (AOR = 2.63; 95% CI = 1.61–4.29), availability of essential medicines (AOR = 2.11; 95% CI = 1.35–3.29), provider attitude (AOR = 1.98; 95% CI = 1.24– 3.16), and shorter waiting time (AOR = 1.76; 95% CI = 1.10–2.82) as significant predictors of healthcare service utilization. The study concludes that there is a significant improvement in access to healthcare services among students due to TISHIP, however, there are ways in which it can be improved through better communication strategies, timely delivery of services, ensuring continuity of basic medicines in school and implementing continuous quality improvement. Improving the use of development communication approaches and stakeholder involvement will help to enhance the utilization of health services, health service user satisfaction, and achieve universal health coverage among students of the university. jpaswr
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