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INTRODUCTION: In Nigeria, inequity and poor accessibility to quality health care has been a persistent problem. This study aimed to determine knowledge and attitude of civil servants in Osun state towards the National Health Insurance Scheme (NHIS). METHODOLOGY: This is a descriptive, cross sectional study of 380 civil servants in the employment of Osun state government, using multi stage sampling method. The research instruments was pre-coded, semi structured, self administered questionnaires. RESULTS: About 60% were aware of out of pocket as the most prevalent form of health care financing, while 40% were aware of NHIS, television and billboards were their main sources of awareness, However, none had good knowledge of the components of NHIS, 26.7% knew about its objectives, and 30% knew about who ideally should benefit from the scheme. Personal spending still accounts for a high as 74.7% of health care spending among respondents but respondents believed that this does not cover all their health needs. Only 0.3% have so far benefited from NHIS while 199 (52.5%) of respondents agreed to participate in the scheme. A significant association exists between willingness to participate in the NHIS scheme and awareness of methods of options of health care financing and awareness of NHIS (P < 0.05) CONCLUSION: Poor knowledge of the objectives and mechanism of operation of the NHIS scheme characterised the civil servants under study. The poor knowledge of the components and fair attitude towards joining the scheme observed in this study could be improved upon, if stakeholders in the scheme could carry out adequate awareness seminars targeted at the civil servants.
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