Socio-demographic correlates of perception and awareness of out-of-pocket health expenditures among household heads in gwagwalada area council, abuja, nigeria

Abstract

In Nigeria, the healthcare financing landscape is dominated by out-of-pocket (OOP) payments. Although the National Health Insurance Scheme (NHIS) was launched in 1999 to mitigate financial hardship, its optional and limited coverage leaves many Nigerians vulnerable. This study aimed to assess the perception, awareness of OOP health expenditures and to explore their associations with socio-demographic characteristics among household heads in Gwagwalada Area Council, Abuja. A descriptive cross-sectional study was conducted among 255 household heads using a cluster sampling method. Data were collected via interviewer-assisted questionnaires and analyzed using SPSS version 21. Descriptive statistics were computed, and Chi-square tests were employed to identify associations at a 5% significance level. The majority of respondents were male (86.3%), married (63.9%), and had attained tertiary education (44.3%). About 97.6% viewed OOP health spending unfavorably. Awareness was generally high (81.2%), but significantly lower among respondents from low socio-economic classes (p<0.05). Only 32.5% were enrolled in NHIS. Socio-demographic factors such as age, education, and religion significantly influenced both perception and awareness (p<0.05). High levels of perception and awareness of OOP expenditures exist among household heads particularly among low-income groups. To enhance healthcare utilization and financial protection, targeted policy efforts are needed to expand NHIS coverage and address socio-economic disparities.