Background: A crucial requirement for the advancement of women's development is the enhancement of maternal and reproductive health. Since 1991, the Zambian government has made tackling healthcare issues a priority. Among the measures implemented, the National Health Insurance Scheme (NHIS) has been a significant emphasis. Created by the National Health Insurance Act No. 2 of 2018, the scheme is overseen by the National Health Insurance Management Authority (NHIMA). This study intends to assess the contribution of the National Health Insurance Scheme (NHIS) to the quality of maternal and reproductive health services in Zambia.

Methods: The study employed a quantitative research approach, using a descriptive cross-sectional design to assess the contribution of the National Health Insurance Scheme (NHIS) to the quality of maternal and reproductive health services in Zambia. A simple random sampling method was applied to select participants, and Cochran's formula was used to calculate a sample size of 320 NIHS policyholders. Data were collected using a well-structured self-administered questionnaire. Data were then cleaned, coded, and analyzed using Stata 14.0. Ethical approval was obtained, and informed consent ensured confidentiality and voluntary participation.

Results: The study indicates that NHIS policyholders' satisfaction with the nurse-to-doctor ratio is moderately positive, with 47% satisfied and 39% neutral. However, 14% expressed dissatisfaction, which suggests room for improvement in interpersonal interactions. Alarmingly, 46% of respondents were dissatisfied with the doctor-patient ratio. This raises concerns about the quality of care and doctors' ability to provide adequate attention to each patient. While satisfaction ratings indicate a mixed response, the relatively high percentage of neutral responses — 47% for imaging services and 36% for general patient care — highlights potential uncertainty or variability in services. Continuous training and quality assurance programs could help improve perceptions in these areas. On the other hand, the high dissatisfaction rate (50%) concerning patient waiting time indicates a significant area for improvement. The quality of care directly impacts maternal and reproductive health outcomes, highlighting the need for ongoing investments in healthcare infrastructure and workforce training.