1.1 Background of the study

Health insurance is a social security system that guarantees the provision of needed health services to persons on the payment of taken contributions at regular intervals. The first attempt at adopting a health insurance system, Nigeria started in 1962 during the first republic. The federal government invited Dr. Halevi through the international labour organization (120) to look into starting a health insurance system in Lagos. Then minister for health Dr. Majekodunmi also presented the first bill to the parliament. When a committee was commissioned to study the national insurance (Oji, 2003). The health population and indeed work force are indisputable tools for rapid socio-economic and sustainable development the world over. Despite thus indisputable fact, in Nigeria like most Africa countries, the provision of quality accessible and affordable health care remark a serious problem (WHO, 2007, Oba, 2008), thus is because the health sector is permeably face with cross shortage of personnel, inadequate and outdated medical equipment policy inconsistence and corruption. Other factor that impede quality health care delivery IN Enugu include inability of the consume to pay for health services gender bias due to religious or cultural beliefs and inequality in the distribution of health care facilities between urban and rural areas. In 2007 for instance, world health organization (WHO) report on health care delivery ranked Nigeria 187 out of 191 countries than in 2005 only 48 and 35 percent of the children within the age of zero to one year old were fully immunized against tuberculosis and measles respectively between 1998 and 2005, 28 percent of the children with in the ages of 5 years who suffered from diarrhea received and equate treatment. A social health insurance scheme involves contribution base on means and utilization based on need.

A health insurance scheme has been define as an arrangement in which contribution are made by or behalf of employees or individual (members) to purchasing institution (a fund) which is responsible for purchasing coursed services from providers or behalf of the members of the scheme (Kutzin) 1997. It is the opinion of Nigeria government that the NHIS will probably provide effective health care services and help to improve accessibility to health care services and help to improve accessibility to health care services (Ibwaye 2007). But the assessment of the programme after four years of operation reveals less than 3% coverage (Ikpong: 2007), and these was as a result of poor implement of the scheme in Nigeria. This research will evaluate the effect of national health insurance in enhancing health care delivery in Enugu.

1.2 STATEMENT OF THE PROBLEM

 The following are problems that prompted the research of this project work:

1.  Failure to understand the significant contribution of effective and efficient national insurance scheme in Enugu.

2.  Failure on the part of the Nigeria government to enhance easy accessibility of national health insurance scheme.

3.  Poor effective administration and management of the activities and operation of the national health insurance scheme in Enugu.

4.  Unawareness of the existence, roles, important benefits and workability of national health insurance scheme.

1.2 OBJECTIVE OF THE STUDY

The following are the objectives of the research work:

1. To find out the significant contributions of effective and efficient national insurance scheme in Nigeria.

2. To find out whether the government enhance easy accessibility of the national insurance in Enugu.

3. To examine whether there is any awareness of the existence, roles, important benefits and workability of the business activities of national insurance scheme in Enugu.

4. To find out the problems facing effective and efficient administration and management of national insurance scheme in Enugu.

1.4 RESEARCH HYPOTHESES

For the successful completion of the study, the following research hypotheses were formulated by the researcher;  

H0: there are no significant contributions of effective and efficient national insurance scheme in Nigeria.

H1: there are significant contributions of effective and efficient national insurance scheme in Nigeria.

H02:  Governments do not enhance easy accessibility of the national insurance in Enugu.

H2: Governments enhance easy accessibility of the national insurance in Enugu.

1.5 SIGNIFICANCE OF THE STUDY

This study will give a clear insight the evaluation of the effect of national health insurance scheme in enhancing health care delivery. The study will be beneficial to insurance company and the general public. The study will also serve as a reference to other researchers that will embark on this topic.

1.6 SCOPE AND LIMITATION OF THE STUDY

The scope of the study covers the evaluation of the effect of national health insurance scheme in enhancing health care delivery. The researcher encounters some constrain which limited the scope of the study;

a) AVAILABILITY OF RESEARCH MATERIAL: The research material available to the researcher is insufficient, thereby limiting the study

b) TIME: The time frame allocated to the study does not enhance wider coverage as the researcher has to combine other academic activities and examinations with the study.

c) Organizational privacy: Limited Access to the selected auditing firm makes it difficult to get all the necessary and required information concerning the activities 

1.7 DEFINITION OF THE STUDY

 NATIONAL HEALTH INSURANCE SCHEME: National Health Insurance Scheme refers to a health insurance program set up by the National government.

HEALTH: Health is the ability of a biological system to acquire, convert, allocate, distribute, and utilize energy with maximum efficiency

ENHANCING: intensify, increase, or further improve the quality, value, or extent of

HEALTH CARE DELIVERY: The delivery of modern health care depends on groups of trained professionals and paraprofessionals coming together as 

1.8 ORGANIZATION OF THE STUDY

This research work is organized in five chapters, for easy understanding, as follows 

Chapter one is concern with the introduction, which consist of the (overview, of the study), historical background, statement of problem, objectives of the study, research hypotheses, significance of the study, scope and limitation of the study, definition of terms and historical background of the study. Chapter two highlights the theoretical framework on which the study is based, thus the review of related literature. Chapter three deals on the research design and methodology adopted in the study. Chapter four concentrate on the data collection and analysis and presentation of finding.  Chapter five gives summary, conclusion, and recommendations made of the study