ABSTRACT National Health Insurance Scheme (NHIS) is a system of healthcare financing introduced by Federal Government of Nigeria to help reduce the risks and minimize the costs of healthcare. Since its inception, only the Formal Sector Social Health Insurance Programme (FSSHIP) has comprehensively taken off. This study investigated the knowledge and perception of Federal Civil Servants in Abuja Municipal Area Council (AMAC), Federal Capital Territory (FCT). A sample size of 383 Civil Servants were selected. The instrument for data collection was a researcher – designed 30 item questionnaire. Data were analysed using descriptive statistics such as frequencies, percentages, mean and standard deviation. Hypotheses were tested using inferential statistics such as student’s t-test and Chi-square. Findings showed that majority of the civil servants (56.3%) had fair knowledge of NHIS programme. The civil servants had a positive perception of the NHIS programme (Overall Mean = 2.81). Majority of the respondents (60%) accessed care under the scheme. Findings from the study also showed that the civil servants who utilized the scheme had a better perception of the programme (mean = 2.84) when compared to those who didn’t (P = 0.038). Education was significantly associated with knowledge and positive perception of the programme. There was no association between grade level and knowledge of NHIS programme. In addition, their perception of the programme was not dependent on their gender. The study concluded that intensified campaign on the objectives, benefits and workings of the scheme should be ensured. This should be facilitated by the nurses and use of mass media in order to reach a vast majority of the workforce and enhance their perception of the programme. 14 CHAPTER ONE INTRODUCTION Background to the Study Health system are designed to improve the standard of health care of the population. Improved funding and management of health systems lead to social stability. Population’s coverage is a clear indicator of the performance of the health system. The policy of National Health Insurance Scheme (NHIS) aims at increasing coverage of the Nigerian population. Health insurance as a health care financing mechanism has become a sought-after approach to the problem of financing healthcare all over the. world. The current concern with financing, and the specific interest in health insurance is often the result of parallel trend; the recognition of basic healthcare for all citizens as a fundamental human right on the one hand, and the difficulties faced by governments in developing and maintaining resources to provide health care through general taxation revenue on the other (Mgbe & Kelvin, 2014). World Health Organization (WHO) has been giving tremendous support and cooperation to nations that pursue their citizen’s welfare through health insurance. They further noted that, nations equally are channeling large chunk of their budget to the attainment of good health for their people. Health insurance can be categorized as social (or government) health insurance and private health insurance. Where a system is financed by compulsory contributions mandated by law or taxes and the system provisions as specified by legal status, it is social (or government) health insurance plan. On the other hand, private health insurance is usually financed on a group basis but most plans also provide for individual policies (Adeoye, 2015). Health Insurance, according to (Adeoye, 2015) is assuming the status of a global phenomenon. It was first introduced in Germany in 1883 under General Von Bismark’s old age and disability insurance scheme. Since then, health insurance has continued to gain prominence in the other industrialized nations like France, United Kingdom etc. Developing countries too have joined in beaming their health search light on health insurance. Prominent among them are Costa-Rica, Brazil, Bangladesh, 15 China, India, Pakistan, Thailand, etc. In Africa it has been introduced in Tanzania, Kenya, Ghana, South Africa, Zimbabwe etc (Agada-Amade, 2007). In Nigeria, the rising cost of medical care, coupled with poor funding of the health care sector by government, in addition to severe down turn in the Nigerian Economy in the 1980’s and 1990s resulted in the abysmal patronage of the orthodox medical and other healthcare or health institutions (Afoloyan-Oloye,2008). Most of these health institutions either down-sized or closed down completely and their health practitioner’s brain-drained for greener pasture. Majority of the people according to Afoloyan-Oloye (2008) resorted to patronizing alternative health care practitioners, such as the herbalists and the spiritualists. Mortality from common diseases became the order of the day. This resulted in government implementing various intervention designs which included the Bamako initiative, user-fee and Drug Revolving Fund. After several committees and commissions, the Federal Government approved the National Health Insurance Scheme (NHIS) in 1989 as a viable means of health care financing for the achievement of easy access to quality health care for the Nigerian people (Adeoye, 2015). It was formally launched on October 15, 1997 and the decree was signed into law in May 1999. National Health Insurance Scheme (NHIS) is a body established under Act 35 of 1999 by the Federal Government of Nigeria to improve the health of all Nigerians at an affordable cost (Adeoye, 2015). NHIS according to Mgbe & Kevin (2014), is a social security system adopted by Nigerian Government to guarantee the provision of needed health services to persons on the payment of token contribution to the common pool, at regular intervals. In the context of this study, NHIS is a system of health care financing introduced by Federal Government of Nigeria to address the problems of health care delivery which has been affected by challenges. It can be seen as a typical example of Public Private Partnership [PPP] in health care delivery in Nigeria. Its main goal is to enhance the health status of the citizens through provision of financial risk protection and customer satisfaction. The hope of the average Nigerian to have a reliable and affordable healthcare delivery system has been brightened with the take-off of the long awaited National Health Insurance Scheme (Mgbe & Kevin, 2014).