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Introduction: Utilization of Health Insurance Scheme services varies for a variety of reasons but it appears that the determining factors are universal.TISHIP was developed to counteract the detrimental effects of user fees which sometimes lead to catastrophic health expenditures. This study aimed to ascertain level of awareness and utilization of TISHIP in tertiary institution in NigeriaMethods: The study was carried out among full time undergraduate studentsEnugu State University of Science and Technology, Enugu state. Nigeria. Analytical cross sectional study design involving use of questionnaire was done. Chi Square test and Binary logistic regression were used to ascertain socio-demographic factors influencing utilization of TISHIP.Results: Majority of respondents were aged 21-25 years 149(48.7%) and lived off-campus 267(87.3%). About 137(44.8%) were aware of TISHIP with major source of awareness from friends/relatives 82(59.8%). Also 60% had positive attitude, 88(28.8%) has registered for the programme and 46(52.3%0 registered >1 year ago.Major factors influencing TISHIP includes; long waiting time 195(63.7%) and poor attitude of the medical staff 186(60.8%). There were statistical significant associations between use of TISHIP with address, education and occupation of both parents. (p< 0.05). Identified predictors were being females (AOR 0.74; 95% CI 0.35-0.96), living in hostel (AOR 3.24; 95% CI 1.52-6.77), father being civil/public servant (AOR 2.34; 95% CI 1.66-5.61) and mother being civil/public servant (AOR 3.13; 95% CI 1.02-7.54).Conclusion: The study showed that knowledge on TISHIP was poor, Also utilization of TISHIP was poor However, majority had positive attitude on TISHIP. There is need for improvement especially as regards sensitization and dissemination on availability of TISHIP to achieve the set objective of the programme.Key words: Tertiary, Health, Insurance, Students

Introduction: The preference for the place of practice plays a vital role in the distribution of human resources for health. Research evidence points at specific medical student characteristics and preferences that can predict their practice preferences. This study aims to ascertain medical students' perception and willingness to practice in rural areas after graduation.Methods: The study was carried out among 400-600 level undergraduate medical students at University of Nigeria Enugu Campus in Enugu metropolis, Enugu state. Nigeria. An analytical cross sectional study design involving use of questionnaire was done. Chi Square test and Binary logistic regression were used to ascertain socio-demographic factors associated with willingness to practice in rural areas.Results: Majority of respondents were aged 21-25 years 134(67.0%), males 133(66.5%) and parents lives in urban area 166(83.0%),. About 6(3.0%) were satisfied on current status of rural health service, 132(66.0%) stated that medical training for rural practice were adequate while 67(33.5%) were willing to work in rural area. There was statistically significant association of father's occupation with willingness to practice in rural area (p=0.017). Determinant identified was fathers being farmers 1.4 times (AOR 1.143; 95% CI 1.27-1.84).Conclusion: Perception of working in rural areas was good, while the willingness was poor. The major reasons for not willing to work in rural area includes; low standard of living and poor educational opportunities for children Giving doctors special allowances and changing duration of rural postings will encourage them to look forward to working in rural areas.Keywords: Perception, willingness, practice, rural area