PATIENTS’ SATISFACTION AND HEALTH CARE SERVICE QUALITY IN THE NIGERIAN NATIONAL HEALTH INSURANCE SCHEME: A SYSTEMATIC REVIEW OF METHODOLOGICAL INSTRUMENTS

This study presents a systematic review of methodological instruments used in assessing patient satisfaction and healthcare service quality within the Nigerian National Health Insurance Scheme (NHIS). Despite the NHIS’s objective to provide affordable and accessible healthcare to Nigerians, existing literature reveals significant methodological inconsistencies in evaluating its performance. The review critically examines data collection, processing, and analysis techniques used in selected peer-reviewed studies from 2000 to 2024, sourced from five academic databases. The findings are organized into three thematic areas: overreliance on basic descriptive and associative tools, limited application of advanced statistical techniques, and fragmented use of qualitative methods. Most studies utilize descriptive statistics and chi square tests without accounting for confounding variables or validating assumptions, thereby limiting their analytical depth. While a few studies attempt regression and mixed-methods designs, they often lack contextual adaptation and methodological rigor. Additionally, qualitative analyses frequently rely on predetermined coding frameworks, restricting the emergence of nuanced insights. The study concludes with a call for more robust, theory-driven, and integrative methodological frameworks that combine multivariate statistical modelling with inductive qualitative analysis. Such approaches are essential for producing more accurate, generalizable, and policy-relevant evaluations of patient satisfaction and service quality under the NHIS, ultimately enhancing healthcare delivery outcomes in Nigeria.