BRIDGING THE HEALTHCARE UTILIZATION GAP: A CASE FOR INSTITUTIONALIZED SOCIAL HEALTH INSURANCE AT KADUNA STATE COLLEGE OF EDUCATION, GIDAN-WAYA, NIGERIA
DOI:
https://doi.org/10/3303/jees.2026.0301/028Keywords:
Financial risk protection, okanagan charter, out-of-pocket expenditure, socio-economic status, socio-spatial theory, universal health coverageAbstract
Despite global commitments to Universal Health Coverage, tertiary students in Nigeria remain inadequately protected from healthcare-related financial risks. This study examined the healthcare utilization gap at Kaduna State College of Education, Gidan-Waya, using a descriptive survey design and a multistage sampling technique to select 357 respondents from a population of 5,335 full-time NCE students. The findings reveal a substantial disconnect between healthcare needs and service utilization: 73% of students reported unmet medical needs, while no institutional free medical outreach programme was implemented during the seven years (2018–2025). Pearson correlation analysis showed a strong positive relationship between parental socio-economic status and healthcare access (r = 0.75, p < 0.001). The coefficient of determination (R² = 0.56) indicates that household financial capacity accounts for more than half of the variation in healthcare utilization. The findings further suggest that reliance on out-of-pocket payments poses significant challenges for economically vulnerable students, thereby reinforcing inequities in access to care. The study concludes that existing institutional arrangements are inconsistent with UHC principles and the Okanagan Charter for Health-Promoting Universities and Colleges. It therefore recommends the operationalization of the Tertiary Institutions Social Health Insurance Programme and its integration with the Kaduna State Contributory Health Management Authority to promote equitable and sustainable access to healthcare for students.
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