Assessing patient satisfaction with the services provided under the National Health Insurance Scheme at the Outpatient Department of the Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

The National Health Insurance Scheme (NHIS), introduced in Zambia in 2019 to enhance healthcare financing and service delivery, still faces challenges impacting patient satisfaction. This study assesses and investigates the factors influencing patient satisfaction with NHIS-provided services at a third-level tertiary public hospital. The study was conducted at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, deliberately chosen as one of the largest publicly financed tertiary referral hospitals and among the first NHIS-accredited facilities. A cross-sectional survey was conducted with 270 respondents using a modified SERVQUAL 5-point Likert scale questionnaire, whose reliability was assessed via Cronbach’s Alpha. Data were analysed using descriptive and inferential statistics, with mean satisfaction percentages calculated. The results showed that 83% of the respondents were satisfied with the NHIS-provided services and 17% were not. Education level, duration of NHIS enrollment, communication from the National Health Insurance Management Authority (NHIMA), drug availability, staff attitude, and waiting time were identified as significant factors. However, the key predictors of NHIS patient satisfaction identified were employment status (OR = 0.237, p = 0.030) and communication and feedback from NHIMA (OR = 2.922, p = 0.001). While these findings show a high NHIS satisfaction level similar to some studies conducted in Nigeria and Ghana, future research should explore the long-term effects and satisfaction levels, including the accessibility and affordability of NHIS services across various demographic groups and regions within Zambia.