Analysing the determinants of healthcare insurance uptake in Nigeria.

Low health insurance coverage has remained a persistent challenge in Nigeria, restricting access to healthcare despite the coexistence of various insurance schemes. While previous research has primarily focused on the National Health Insurance Scheme (NHIS) or community-based health insurance (CBHI), few studies have collectively examined the factors influencing enrolment across different types of insurance-namely, community-based, employer-sponsored, and private schemes. This study addresses this research gap using household data from the 2018 Nigeria Demographic and Health Survey (DHS). Employing logit and probit regression models, the analysis explores the likelihood of health insurance enrolment. The results reveal that six socioeconomic factors-education attainment, age of the household head, bank account ownership, wealth status, marital status, and employment type-significantly influence enrolment in both overall insurance (all types of insurance) and employer-sponsored insurance. However, these factors vary in importance for community-based and private insurance. For instance, individuals with low education have a higher likelihood of enrolment in CBHI than those with high education. The study also finds that financial constraints may reduce the possibility of enrolment among low-income groups compared to their middle- and high-income counterparts. The findings underscore the need for targeted interventions to enhance enrolment, particularly among individuals with lower educational levels, limited income, and those employed in the informal sector.