Comparative Study of Enrollee Satisfaction with Private and Public Health Care Providers of Community Based Health Insurance Scheme in Edu LGA, Kwara State

Introduction: Many low and middle income countries keep on searching for different ways of financing their health systems. In order to ensure accessibility to quality health services by those in the rural areas, a Community Based Health Insurance Scheme was initiated which aim to integrate both human and financial resources within the rural communities to provide basic healthcare services to its resident. In recent years, level of patient satisfactions have been identified as one of the major yardsticks to measure quality of healthcare. This study was conducted to compare enrollees satisfaction of public and private providers of community based health insurance scheme in Edu Local Government Area of Kwara State, Nigeria.

Materials and Methodology: A descriptive cross sectional study was carried out among eight hundred respondents that were selected using multistage sampling technique. Data was collected using a semi-structured interviewer administered questionnaire and Focus Group Discussion. Analysis was done with EPI info software and confidence level was held at 95% and a p-value of less than 0.05 was considered as statistically significant.

Results: The satisfaction level with private facility (4.28±0.35) was higher than that with public facilities (4.12 ±0.48). The difference was significant at a p-value of <0.001. Private providers had a higher satisfaction level than the public providers in the domains of empathy, tangibles, assurance and timeliness. The difference was statistically significant as the p-value was less than 0.05. No differences in level of satisfaction in responsiveness among the respondents of both providers as the p-value was 0.295. There was an association between marital status and satisfaction in public providers while an association occur between type of marriage and satisfaction in private provider. There was an association for both providers in occupation level, level of education and length of enrolment.

Conclusion and Recommendation: There was a higher overall satisfaction among enrollees of private providers than the public providers of Community Based Health Insurance Scheme. Health care delivery by private providers is of good quality and as such private facilities should be maintained as part of the providers of Community Based Health Insurance Scheme. Government should also strengthen monitoring and supervision to ensure good quality of health care delivery to the enrollees especially in the public health facilities.