Evaluating the Impact of the Ebonyi State Health Insurance Scheme on Healthcare Access, Outcomes, and Financial Protection

By: Ohalete Cynthia Chekwube, Ohalete Precious Ifeanyi

Pages: 1–17, Volume: 2, Number: 2

Published by: AEFUNAI Journal of Economics, Finance and Development Studies, Alex Ekwueme Federal University, Ndufu-Alike, 9/1/2025, 2025

ISSN (Electronic): 2536-6742

DOI: 10.48028/iiprds/aefunaijefds.v2.i2.01

Evaluating the Impact of the Ebonyi State Health Insurance Scheme on Healthcare Access, Outcomes, and Financial Protection

Abstract:

This study evaluates the impact of the Ebonyi State Health Insurance Agency (EBSHIA) scheme on healthcare utilisation, health status, and cost reduction in Nigeria. Public health insurance schemes are designed to enhance access, improve outcomes, and reduce out-of-pocket (OOP) spending, yet subnational evidence in Nigeria remains limited. Using a mixed-methods approach, primary survey data from 314 enrollees were analysed through descriptive statistics and ordinal logistic regression, with self-reported health improvement and frequency of medicine access as dependent variables, and socio- demographics, facility type, EBSHIA package, and utilisation frequency as independent variables. Findings show that post-enrolment, 70.1% of respondents reported increased facility visits, 86% experienced improved health status, and all reported reduced OOP costs. Education, visit frequency, facility type, and package significantly predicted outcomes (Nagelkerke R² = 0.724), while income was the strongest determinant of cost reduction, with low-income groups benefiting most (p < 0.001). The results demonstrate that EBSHIA effectively improves healthcare utilisation, health outcomes, and affordability, particularly among economically vulnerable groups. It is recommended that policymakers expand outreach to low-education and informal sector populations, enhance equity-based enrolment, refine package design, and strengthen primary healthcare delivery to maximise scheme impact.

Keywords: Health insurance, Ebonyi State, Universal Health Coverage, Healthcare access, Health outcomes