National Health Insurance Scheme and Healthcare Delivery Effectiveness in Nigeria Military Hospital, Port Harcourt, 2015-2025

The effectiveness of healthcare delivery within any national health insurance framework depends fundamentally on the institutional capacity of facilities responsible for translating coverage into care. In Nigeria, the National Health Insurance Scheme (NHIS), operational since 2005, continues to confront significant implementation gaps at the facility level, where provider competence, personnel adequacy, and service continuity remain critical yet underexamined determinants of sustainable healthcare delivery. This study examined the relationship between healthcare delivery effectiveness and the National Health Insurance Scheme at the Nigeria Military Hospital, Port Harcourt, 2015-2025, focusing on the role of healthcare providers, adequacy of medical personnel, and healthcare delivery continuity. Anchored on Systems Theory and Donabedian’s Quality of Care Theory, the study was guided by three objectives, three research questions, and three null hypotheses. A mixed-method correlational survey design was adopted from a population of 15,035 persons; 390 respondents were determined using Taro Yamane’s formula through proportional stratified sampling, and 366 questionnaires were retrieved and usable (93.8% response rate), complemented by interviews with 15 key informants. Cronbach’s Alpha reliability coefficients were 0.839, 0.796, and 0.812. Data were analysed using descriptive statistics and PPMC at the 0.05 significance level, with r-values converted to t-values for independent confirmation. Findings revealed statistically significant positive relationships between sustainable healthcare delivery and the role of healthcare providers (r = 0.643, p < 0.05), adequacy of medical personnel (r = 0.602, p < 0.05), and healthcare delivery continuity (r = 0.627, p < 0.05). The military institution’s culture of professional discipline and 24-hour operational readiness emerged as structural advantages, while personnel shortages, specialist attrition, and chronic disease management gaps were identified as binding constraints. All three null hypotheses were rejected. The study recommended a formal NHIS administrative training programme, a staffing establishment review with retention incentives, and a dedicated chronic disease management programme.

Healthcare delivery effectiveness, healthcare providers, medical personnel adequacy, National Health Insurance Scheme, sustainable healthcare delivery

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