(PDF) The Impact of Delta State Contributory Health Scheme on Workers Health Attitude, Behaviour and Practice in Delta State Civil Service

TITLE PAGE

Certification

Dedication

Acknowledgement

CHAPTER ONE: INTRODUCTION

1.1 Background of the study

1.2 Statement of the problem

1.3 Objective of the study

1.4 Research question

1.5 Significance of the study

1.6 Scope of the study

1.7 Limitation of the study

1.8 Definition of terms

CHAPTER TWO: REVIEW OF LITERATURE

2.1 Conceptual framework’

2.2 Theoretical Framework

CHAPTER THREE: RESEARCH METHODOLOGY

3.1 Introduction

3.2 Research Design

3.3 Population of the study

3.4 Sample size determination

3.5 Sample size selection technique and procedure

3.6 Research Instrument and Administration

3.7 Method of data collection

3.8 Method of data analysis

3.9 Validity of the Study

3.10 Reliability of the study

3.11 Ethical Consideration

CHAPTER FOUR: DATA PRESENTATION AND ANALYSIS

4.1 Data Presentation

4.2 Research Hypothesis

CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATION

5.1 Summary

5.2 Conclusion

5.3 Recommendation

References

Appendix

Abstract

This study was on the impact of Delta state contributory health scheme on workers health attitude, behavior and practices in Delta state civil service, Asaba. Four objectives were raised which included: To determine the health attitude of Civil Servants in Delta state on Contributory Health scheme, to determine the behaviour of Civil Servants in Delta state on Contributory Health scheme programme, ascertain the practice of Civil Servants in Delta state on Contributory Health scheme programme and to find out the differences in the opinion of users and the non-users of the Contributory Health scheme programme among Civil Servants in Delta state. In line with these objectives, four research questions were formulated and answered. The total population for the study is 200 civil servants of Delta state civil service. The researcher used questionnaires as the instrument for the data collection. Descriptive Survey research design was adopted for this study. A total of 133 respondents made directors, administrative staff, senior staff and junior staff were used for the study. The data collected were presented in tables and analyzed using simple percentages and frequencies

Chapter one

Introduction

Background of the study

Health system are designed to improve the standard of health care of the population. Improved funding and management of health systems lead to social stability. Population’s coverage is a clear indicator of the performance of the health system. The policy of contributory health scheme (CHS) Healthcare Financing organization established by the Delta State Government to ensure access to quality healthcare services for all residents of Delta State irrespective of their socio-economic status and geographical location, in an effort to achieve the United Nations’ Sustainable Development Goal 3 in the year 2030. Health insurance as a health care financing mechanism has become a sought-after approach to the problem of financing healthcare all over the. world. The current concern with financing, and the specific interest in health insurance is often the result of parallel trend; the recognition of basic healthcare for all citizens as a fundamental human right on the one hand, and the difficulties faced by governments in developing and maintaining resources to provide health care through general taxation revenue on the other (Mgbe & Kelvin, 2014). World Health Organization (WHO) has been giving tremendous support and cooperation to nations that pursue their citizen’s welfare through health insurance. They further noted that, nations equally are channeling large chunk of their budget to the attainment of good health for their people.

Health insurance can be categorized as social (or government) health insurance and private health insurance. Where a system is financed by compulsory contributions mandated by law or taxes and the system provisions as specified by legal status, it is social (or government) health insurance plan. On the other hand, private health insurance is usually financed on a group basis but most plans also provide for individual policies (Adeoye, 2015). Health Insurance, according to (Adeoye, 2015) is assuming the status of a global phenomenon.

In Nigeria, the rising cost of medical care, coupled with poor funding of the health care sector by government, in addition to severe down turn in the Nigerian Economy in the 1980’s and 1990s resulted in the abysmal patronage of the orthodox medical and other healthcare or health institutions (Afoloyan-Oloye,2008). Most of these health institutions either down-sized or closed down completely and their health practitioner’s brain-drained for greener pasture. Majority of the people according to Afoloyan-Oloye (2008) resorted to patronizing alternative health care practitioners, such as the herbalists and the spiritualists. Mortality from common diseases became the order of the day. This resulted in government implementing various intervention designs which included contributory health scheme.

Contributory health scheme according to Mgbe & Kevin (2014), is a social security system adopted by Nigerian Government to guarantee the provision of needed health services to persons on the payment of token contribution to the common pool, at regular intervals. In the context of this study, Contributory health scheme is a system of health care financing introduced by Delta state government to address the problems of health care delivery which has been affected by challenges. It can be seen as a typical example of Public Private Partnership [PPP] in health care delivery in Nigeria. Its main goal is to enhance the health status of the citizens through provision of financial risk protection and customer satisfaction. The hope of the average Nigerian to have a reliable and affordable healthcare delivery system has been brightened with the take-off of the long awaited National Health Insurance Scheme (Mgbe & Kevin, 2014).

Statement of the Problem

The introduction of contributory health scheme (CHS) as a health care financing mechanism should be welcomed with enthusiasm and sense of relief by all stakeholders in the health care industry, especially state Civil Servants in Delta state. Dogo (2008), are of the opinion that Contributory Health Scheme, which is a health care risk spreading mechanism is probably what is required to solve the problem of inequality in the provision of health care services in Delta state. Thus the scheme was proposed to help spread the risks and minimize the costs of health care. Regrettably the emergence of CHS seems not to gain the much expected acceptance, support and cooperation from the civil servants. Ononokpo (2010) observed that majority of civil servants are still reluctant with accepting CHS programme. According to him, they are all suspicious of government’s motive, intention and strategies especially when they realize that there will be monthly deduction from their salaries as their contribution into the “solidarity pool” for running the scheme. Anecdotal records and personal experience as a health care worker with the CHS have shown that many civil servants fail to access the CHS services. Moreso, there is dearth of literature on why many of these civil servants who are expected to be aware of the services and the benefits do not access the service. The questions raised in this study are: what knowledge do the state Civil Servants have concerning CHS programme? What is the attitude of Federal Civil Servants in Delta state on CHS program. What is the behavior of the Federal Civil Servants on the quality of care provided by the CHS programme? This study is an attempt to address the above questions.

Objective of the study

The objectives of the study are;

To determine the health attitude of Civil Servants in Delta state on Contributory Health scheme.
To determine the behaviour of Civil Servants in Delta state on Contributory Health scheme programme.
ascertain the practice of Civil Servants in Delta state on Contributory Health scheme programme.
To find out the differences in the opinion of users and the non-users of the Contributory Health scheme programme among Civil Servants in Delta state.

Research question

The study formulated the following research question

What is the health attitude of Civil Servants in Delta state on Contributory Health scheme?
What is the behaviour of Civil Servants in Delta state on Contributory Health scheme programme?
What is the practice of Civil Servants in Delta state on Contributory Health scheme programme?
Are there differences in the opinion of users and the non-users of the Contributory Health scheme programme among Civil Servants in Delta state?

Significance of the study

The findings of the study will reveal the knowledge and perception of Civil Servants in Delta state on Contributory Health scheme programme. If their views and perceptions are positive the civil servants will be encouraged to uphold them by the workers in the Contributory Health scheme. If their views are negative, there will be need for enlightenment of civil servants on the benefit of Contributory Health scheme by the workers in the Contributory Health scheme through special sensitization seminars. If the result indicates that the Civil Servants do not have enough knowledge, it will serve as a reason for the Contributory Health scheme workers, and the government to organize public enlightenment programme and appropriate information on the concept, objectives, roles, and responsibilities, operations of the scheme and benefits of Contributory Health scheme. This will enable Civil Servants to make informed choices on adoption of the scheme. Good understanding and awareness will create positive impact on them. If findings show good knowledge and perception, the civil servants will be encouraged to maintain it. The findings will equally motivate Contributory Health scheme workers and health policy makers to step up effort in the area of sensitization, seminars, and workshops with a view of raising the level of awareness of the people regarding Contributory Health scheme, their engendering positive attitude and adoption of the scheme.

Scope and limitation of the study

The scope of the study covers the impact of Delta state contributory health scheme on workers health attitude, behavior and practices in Delta state civil service, Asaba. The study will be limited to civil servant in Delta state.

This study is limited to the following ways;

TIME CONSTRAINT: The period within which the study is conducted is short for through research study; hence, gathering adequate information becomes very difficult.
FINANCE: This is one of the limitations to the scope of this study as the researcher is facing financial constraint to meet all the needed educational requirements including this research work. This caused the researcher to restrict her research work to one organization for possible study.
LACK OF MATERIALS: Lack of materials to topic is also another limitation to this research work, hence the researcher resolved to seek friendly approach in order to obtain the needed materials or information from the establishment under this study through the administration of questionnaire and oral interview

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