Impact of national health insurance scheme on blood pressure control in Zaria

Background: National Health Insurance Scheme (NHIS) was commenced in Nigeria in 2001 to ensure wider access to health care services. This study determined the impact of NHIS implementation on blood pressure (BP) control among patients with systemic hypertension, regularly attending the Cardiac Clinic, Ahmadu Bello University Teaching Hospital, Shika, Zaria, Nigeria. Materials and Methods: Patients with systemic hypertension, both NHIS and non-NHIS beneficiaries attending a tertiary health facility in Zaria, Nigeria, were seen in a prospective cross-sectional study. Demographic and clinical characteristics were obtained. Access to treatment and relevant investigations were compared. BP levels were analyzed and compared in both groups at enrollment in the clinic and at the point of this study. Results: Sixty-five percent, (70/107) of the clinic attendees were on the NHIS scheme and were significantly younger than non-NHIS patients (t = 2.03, P = 0.03). Mean body mass index (BMI) was equally high (t = −1.222, P = 0.22) and there was similar access to medications (χ2 = 0.08, P = 0.77). Mean systolic BP (SBP) and diastolic BP (DBP) at enrollment were significantly higher in NHIS patients (t = −3.064, P = 0.003 for mean SBP and t = −4.115, P = 0.0001 for mean DBP), respectively. However, BP control in both groups at the end of the study did not show any significant difference (χ2 = 0.02, P = 0.89). Conclusion: NHIS uptake among these patients is high. There was no difference in BP control among the insured and nonbeneficiaries. A study of a larger number of patients over a longer period is suggested.