Household Preferences for Healthcare Financing Mechanisms and Perceived Barriers to Effective Healthcare Financing in Southeastern Nigeria : Implications for Scaling Up Universal Health Coverage

Introduction: A number of reports in Nigeria and other African countries have noted that there have been extensive debates about moving away from out of pocket payments for healthcare to social health insurance mechanisms. However, there is little knowledge about what mechanisms the households would prefer for financing healthcare and what may pose barriers to effective care financing. This paper hopes to fill the gap in knowledge. Methods: The study was a cross-sectional household survey of urban dwellers in Enugu, southeast Nigeria. Data on socio-demographic, preferences for health care financing, and perceived barriers to effective health financing was collected from heads of households or their surrogates. Descriptive statistics was run for all the variables. Results: The households preferred mostly National health insurance scheme [NHIS] [45.1%], out of pocket [28.2%] and community based health insurance scheme [14.1%]. Income, decreased quality of care, incomplete coverage and unemployment were the perceived barriers to effective care financing in the study area. Conclusion: This study provides evidence that households preferred risk pooling mechanisms for financing healthcare which have elements of cost sharing. There should be efforts to popularize such schemes/or mechanisms, and since such mechanisms protect the poor, effort should be made to scale it up to reach larger population especially the informal sector and unemployed masses in Nigeria.