Health insurance, health care utilization and health outcomes in Nigeria: evidence from DHS data

PURPOSE: One vital concern of health policy globally is to achieve equity in access to health care services for all. This study aims to examine the interconnectedness of health insurance, healthcare utilization and health outcomes in Nigeria. It set out to ascertain how enrollment in health insurance impacts healthcare utilization and health outcomes in Nigeria. DESIGN/METHODOLOGY/APPROACH: The study utilized the latest demographic survey data collected by the National Bureau of Statistics in Nigeria. The data was analyzed using binary logistic regression models. FINDINGS: The study demonstrates that father's education and occupation are positively associated with health outcomes, while age and decision on healthcare utilization have negative associations. It also observed that insurance enrollment does not significantly improve child and maternal health outcomes even though insurance ownership and the type of plan significantly influence health service use in Nigeria. This result is further supported by the ordinary least squares regression result, serving as a robustness check. ORIGINALITY/VALUE: The results provide evidence that investments in health insurance infrastructure, educational attainment (especially among men) and geographic equity in service provision are critical levers for improving population health in Nigeria. The study recommends that strengthening the health system in Nigeria requires multidimensional efforts targeting insurance access, educational empowerment, employment stability and geographical service distribution so as to achieve Sustainable Development Goal 3: "Good Health and Well-Being for all."