Student Satisfaction With the Tertiary Institutions Social Health Insurance Programme in Kaduna State, Nigeria: A Comparative Cross-Sectional Study

Abstract

Abstract

Background: Student satisfaction is a key indicator of the acceptability and perceived quality of health insurance-supported services. Within Nigerian tertiary institutions, however, evidence on satisfaction with the Tertiary Institutions Social Health Insurance Programme (TISHIP) remains sparse. This study assessed student satisfaction with TISHIP and compared satisfaction scores across three federal tertiary institutions in Kaduna State, Nigeria.

Methods: This manuscript presents a focused analysis from a broader institution-based cross-sectional survey conducted among full-time students in Ahmadu Bello University, Zaria; Federal Polytechnic, Kaduna; and Federal College of Education, Zaria. A total of 560 questionnaires were distributed proportionately and 400 valid responses were analysed. Satisfaction was assessed with the Patient Satisfaction Questionnaire Short Form (PSQ-18). Mean scores, standard deviations, and percentages of the maximum obtainable score were reported. One-way analysis of variance examined between-institution differences. The study also reported a paired comparison between utilization and satisfaction

Results: The overall satisfaction score was 2.85 ± 1.14, corresponding to 57.0% of the maximum obtainable score. Institution-specific satisfaction percentages were 57.8% in Ahmadu Bello University, 57.4% in Federal Polytechnic Kaduna, and 56.0% in Federal College of Education Zaria. Satisfaction did not differ significantly across institutions (F = 0.063, p = 0.939). Descriptively, satisfaction exceeded utilization in each institution and overall (57.0% versus 45.2%). The study also reported a significant paired difference between utilization and satisfaction composite scores (t = -7.395, df = 399, p < 0.001).

Conclusions: Students rated TISHIP satisfaction somewhat more favorably than programme utilization, yet satisfaction remained only moderate and showed no institutional variation. The findings suggest that the programme may be acceptable to those who reach services, but broader uptake remains constrained. Service quality improvement should therefore be pursued together with better student engagement and easier access pathways.