<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.2d1 20170631//EN" "JATS-journalpublishing1.dtd">
<ArticleSet>
  <Article>
    <Journal>
      <PublisherName>ajhe</PublisherName>
      <JournalTitle>African Journal of Health Economics</JournalTitle>
      <PISSN>C</PISSN>
      <EISSN>o</EISSN>
      <Volume-Issue>Volume 7 Issue 1</Volume-Issue>
      <PartNumber/>
      <IssueTopic>Multidisciplinary</IssueTopic>
      <IssueLanguage>English</IssueLanguage>
      <Season>June 2018</Season>
      <SpecialIssue>N</SpecialIssue>
      <SupplementaryIssue>N</SupplementaryIssue>
      <IssueOA>Y</IssueOA>
      <PubDate>
        <Year>-0001</Year>
        <Month>11</Month>
        <Day>30</Day>
      </PubDate>
      <ArticleType>Review &amp; Research</ArticleType>
      <ArticleTitle>Level and Correlates of Health Insurance Coverage in Nigeria: Evidence from 2013 Nigeria Demographic and Health Survey.</ArticleTitle>
      <SubTitle/>
      <ArticleLanguage>English</ArticleLanguage>
      <ArticleOA>Y</ArticleOA>
      <FirstPage>16</FirstPage>
      <LastPage>27</LastPage>
      <AuthorList>
        <Author>
          <FirstName>Alawode Oluwatobi</FirstName>
          <LastName>Abel</LastName>
          <AuthorLanguage>English</AuthorLanguage>
          <Affiliation/>
          <CorrespondingAuthor>N</CorrespondingAuthor>
          <ORCID/>
        </Author>
      </AuthorList>
      <DOI/>
      <Abstract>Background: Health insurance provides a veritable means of achieving Universal Health Coverage (UHC), i.e., the ability of people to gain access to healthcare they need without experiencing financial hardship as a result. Nigeria has a national health insurance scheme, but coverage has been reported to be very low for various reasons. Gaps exist in literature as previous studies on health insurance in Nigeria have not assessed the level and predictors of ownership of health insurance using a national survey. Hence, this study investigates the level and correlates of health insurance coverage in Nigeria. The findings will be of great importance to health programmers and government and extend the body of knowledge on the determinants of health insurance in Nigeria while also offering recommendations.&#13;
&#13;
Method: Using data from 2013 Nigeria Demographic and Health Survey (n=54,948), individual (women) and men recode were merged, and the data were analyzed at three stages of univariate, bivariate, and multivariate using Stata 14. The bivariate level involved the use of chi-square to determine the association between selected socio-economic and demographic variables and health insurance. The multivariate level involved the fitting of two binary logistic regression models.&#13;
&#13;
Findings: The findings showed that health insurance coverage is low in Nigeria as the majority of the respondents reported not having a health insurance, and the factors that were found to significantly determine ownership of health insurance in Nigeria include; age (OR=1.69; CI: 1.35 - 2.12), level of education (OR = 13.61; CI: 8.15 - 22.70), household wealth index (OR=80.97; CI: 21.31 - 307.65), type of occupation (OR = 1.28; CI: 1.02 - 1.60), ethnicity (OR=1.99; CI: 1.42 - 2.78) and level of exposure to mass media (OR=0.65; CI: 0.48 - 0.87).&#13;
&#13;
Conclusion: The paper concludes that the level of health insurance coverage in Nigeria is low; which does not augur well for plans of achieving UHC. The national government as part of recommendations, should consider subsidizing health insurance coverage not just for government workers but the population at large as it is done at the state levels.</Abstract>
      <AbstractLanguage>English</AbstractLanguage>
      <Keywords>Health Insurance, Nigeria, Universal Health Coverage</Keywords>
      <URLs>
        <Abstract>https://ajhe.org.in/ubijournal-v1copy/journals/abstract.php?article_id=6086&amp;title=Level and Correlates of Health Insurance Coverage in Nigeria: Evidence from 2013 Nigeria Demographic and Health Survey.</Abstract>
      </URLs>
      <References>
        <ReferencesarticleTitle>References</ReferencesarticleTitle>
        <ReferencesfirstPage>16</ReferencesfirstPage>
        <ReferenceslastPage>19</ReferenceslastPage>
        <References>Mhere F. Health insurance determinants in Zimbabwe: Case of Gweru Urban. Journal of Applied Business and Economics. 2013;14(2):62-79.&#13;
	Obare V, Brolan C, Hill P. Indicators for universal health coverage: can Kenya comply with the proposed post-2015 monitoring recommendations? International Journal of Equity in Health. 2014;13(123).&#13;
	Atinga RA, Abiiro GA, Kuganab-Lem RB. (1). Tropical Medicine and Internationl Health. 2015;20(3):312-21.&#13;
	Campbell PC, Owoka OM, Odugbemi TO. National health insurance scheme: Are the artisans benefitting in Lagos state, Nigeria? Journal of Clinical Sciences. 2016;13:122-31.&#13;
	Sieverding M, Onyango C, Suchman L. Private healthcare provider experiences with social health insurance schemes: Findings from a qualitative study in Ghana and Kenya. PLoS ONE. 2018;13(2):: e0192973.&#13;
	Adefolaju T. Repositioning Health Insurance in Nigeria: Prospects and Challenges. International Journal of Health Sciences. 2014;2(2):151-62.&#13;
	Ele GN, Ogbonna BO, Ochei UM, Odili VU. Assessment of National Health Insurance Schemeand;#39;s (NHIS) Effectiveness in a Tertiary Teaching Hospital in Southeast Nigeria. Journal of Advances in Medical and Pharmaceutical Sciences. 2017;13(3):1-9.&#13;
	WHO. Global Health Expenditure Database. World Health Organization: Geneva, Switzerland.: 2012.&#13;
	Dogo-Mohammad M. Importance of standards in a demand driven Health Insurance System.3rd Annual SQHN Conference: Safety, Standards and Customer Service Lagos, Nigeria: Society for Quality of Health Care in Nigeria2011.&#13;
	Onyedibe KI, Goyit MG, Nnadi NE. An evaluation of the national health insurance scheme (NHIS) in Jos, a north-central Nigerian city. Global Advanced Research Journal of Microbiology. 2012;1(1):5-12.&#13;
	Onoka CA, Hanson K, Hanefeld J. Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria. Health Policy and Planning. 2015;30:1105-17.&#13;
	Mulenga JN, Bwalya BB, Gebremeskel Y. Demographic and Socio-economic determinants of womenand;#39;s health Insurance coverage in Zambia Epidemiology Biostatistics and Public Health. 2017;14(1):e12094-1-9.&#13;
	Odeyemi IA, Nixon J. Assessing equity in health care through the national health insurance schemes of Nigeria and Ghana: a review-based comparative analysis. International Journal for Equity in Health. 2013;12(9):1-18.&#13;
	Jia L, Yuan B, Huang F, Lu Y, Garner P, Meng Q. Strategies for expanding health insurance coverage in vulnerable populations. The Cochrane Database of Systematic Reviews. 2014(11).&#13;
	Shiyanbade BW, Makinde WA, Olajide SO, Ogunbela GK, Abdulrasaq N. Re-assessing the collaboration ImplementationStrategies and Administration of National Health Insurance Scheme (NHIS) on End-Users in Nigeria. International Journal of Politics and Good Governance. 2017;VIII(8):1-23.&#13;
	Kimani JK, Ettarh R, Kyobutungi C, Mberu B, Muindi K. Determinants for participation in a public health Insurance program among residents of urban slums in Nairobi, Kenya: results from a cross- sectional survey. BMC Health Services Research. 2012;12(66).&#13;
	Kipaseyia JS. Factors influencing membership uptake ofNational Hospital Insurance Fund among the poor: a pastoralistand;#39; perspective: Strathmore University.; 2016.&#13;
	Kazungu JS, Barasa EW. Examining levels, distribution and correlates of health Insurance coverage in Kenya. Tropical Medicine and International Health. 2017;22(9):1175-85.&#13;
	Kirigia JM, Sambo LG, Nganda B, Mwabu GM, Chatora R, Mwase T. Determinants of health insurance ownership among South African women. BMC Health Services Research 2005;5(17).&#13;
	Masengeli NL, Mwaura-Tenambergen W, Mutai J, Simiyu BW. Determinants of Uptake of Health Insurance Cover Among Adult Patients Attending Bungoma County Referral Hospital. International Journal of Health Economics and Policy. 2017;2(4):145-51.&#13;
	Kiplagat I, Muriithi M, Kioko U. Determinant of Health Insurance Choice in Kenya. European Scientific Journal. 2013;9(33):452-68.&#13;
	Motlagh SN, Gorji HA, Mahdavi G, Ghaderi H. Main determinants of Supplementary Health Insurance Demand: (Case of Iran). Global Journal of Health Science 2015;7(6):285-94.&#13;
	Yellaiah J, Ramakrishna G. Socio economic determinants of health insurance in India: the case of Hyderabad city. International Journal of Development and Sustainability. 2012;1(2):111-9.&#13;
	Dixon J. Determinants of Health Insurance Enrolment in Ghanaand;#39;s Upper West Region. Electronic Thesis and Dissertation Repository 2057. 2014.&#13;
	Dror DM, Hossain SAS, Majumdar A, Koehlmoos TLP, John D, Panda PK. What Factors Affect Voluntary Uptake ofCommunity-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis. PLoS ONE. 2016;11(8):e0160479.&#13;
	Yamada T, Yamada T, Chen CC, Zeng W. Determinants of health insurance and hospitalization. Cogent Economics and; Finance 2014;2(920271).&#13;
	Alkenbrack S, Jacobs B, Lindelow M. Achieving universal health coveragethrough voluntary insurance: what can we learn from the experience of Lao PDR? BMC Health Services Research. 2013;13(521).&#13;
	Workneh SG, Biks GA, Woreta SA. Community-based health insurance and communitiesand;#39; scheme requirement compliance in Thehuldere district, northeast Ethiopia: cross-sectional community-based study. Clinico Economics and Outcomes Research. 2017;9:353-9.&#13;
	Badu E, Agyei-Baffour P, Ofori Acheampong I, Opoku MP, Addai-Donkor K. Households Sociodemographic Profile as Predictors of Health Insurance Uptake and Service Utilization: A Cross-Sectional Study in a Municipality of Ghana. Advances in Public Health. 2018;2018:1-13.&#13;
	Orayo JA. Determinants of Health Insurance among the Migrants in Kenya: University of Nairobi; 2014.&#13;
	Wilcox-Gok V. Health Insurance Coverage amng the Elderly Department of Economics and Institute for Health, J. Rubin Health Care Policy, and Aging Research, 1990Contract No.: 149.&#13;
	Maina JM, Kithuka P, Tororei S. Perceptions and uptake of health insurance for maternal care in rural Kenya: a cross sectional study. Pan Afrian Medical Journal. 2016;23(125).&#13;
	Kimani JK, Ettarh R, Warren C, Bellows B. Determinants of health insurance ownership among women in Kenya: evidence from the 2008-09 Kenya demographic and health survey. International Journal of Equity in Health. 2014;13(27).&#13;
	Ibok NI. Socio-Economic and Demographic Determinants of Health Insurance Consumption. Canadian Social Science. 2012;8(5):58-64.&#13;
	Nandi A, Ashok A, Laxminarayan R. The Socioeconomic and Institutional Determinants of Participation in Indiaand;#39;s Health Insurance Scheme for the Poor. PLoS ONE. 2013;8(6):e66296.&#13;
	Adebayo EF, Ataguba JE, Uthman OA, Okwundu CI, Lamont KT, Wiysonge CS. Factors that affect the uptake of community-based health insurance in low-income and middle-income countries: a systematic protocol. BMJ Open. 2014;4(e004167).&#13;
	Nyorera EN, Okibo W. Factors affecting Uptake of National Hospital Insurance Fund among Informal Sector workers A case of Nyatike Sub-County, Kenya. International Journal of Economics, Commerce and Management. 2015;III(3).&#13;
	PRB. World Population Datasheet with Special focus on changing Age Structures. In: Bureau PR, editor. 1875 Connecticut Avenue, NW, Suite 520, Washington, D.C. 20009 USA 800-877-98812018.</References>
      </References>
    </Journal>
  </Article>
</ArticleSet>