Nigeria ranks low in health insurance scheme
Despite being in operations for over 10 years, National Health Insurance Scheme (NHIS) seems to be failing in meeting its stipulated objectives, as Nigeria still ranks low of 187 among the World Health Organisation (WHO) ranking of 191 countries.
The NHIS was expected to provide social and financial risk protection by reducing the cost of health care and providing equitable access to basic health services to the most vulnerable populations in Nigeria, including children, pregnant women, people living with disabilities, elderly, displaced, unemployed, retirees and the sick.
Although these vulnerable groups sometime benefit from free health care services and exemption mechanisms, however, they largely have to pay for health care services. Free health care services and exemption mechanisms are often politically motivated, and are poorly implemented, and do not become fully operationalised, and sometimes only last a few years.
Key among its failures is the non-realisation of the objective of making health care available to Nigerians at an affordable cost as many Nigerians still pay out of their pocket for medical
expenses, a scenario which has continued to drive many families to catastrophic health expenditures and poverty.
As of February 2018, the country was ranked 187 out of 191 countries in the world in assessing the level of compliance with the Universal Health Coverage (UHC), as very few of the populace are health insured, whereas even government provision for health is almost insignificant.
The NHIS was set up with the objective of making health care accessible and affordable to many Nigerians. The scheme was aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems and also to improve the health status of Nigerians, especially participants of the Scheme.
A report by the second largest professional services firm in the world PricewaterhouseCoopers states that “Access to affordable healthcare continues to be a challenge for most Nigerians due to high levels of poverty and significant reliance on out of pocket payments.
“Health Insurance coverage throughout the country has barely scratched the surface in terms of the country’s population,” the report noted.
PWC the report further stated that several issues contribute to the failure of the scheme, which includes financial constraint, substandard services from the hospitals, poor patronage due to the reluctance of corporate bodies to engage in the scheme and many other reasons.
Another report released by Axa Mansard Plc a member of the AXA Group, the worldwide leader in insurance and asset management showed that Nigeria’s NHIS which was first mentioned in 1962 and implemented 27 years later in 2005 is yet to fully deliver its purpose as a greater part of the populace is yet to access good healthcare much less health insurance.
Another alarming factor was a report by NHIS, which revealed as at 2016 the scheme covered less than 5 per cent of the population and the 5 per cent was largely made up of Federal Government employees and their dependents.
10 years after its existence, the lofty objective of NHIS is still being undermined by many factors ranging from inadequate legal framework for a successful scheme, to poor implementation of the Act, poor government funding of health, Optional enrolment policy, inappropriate practices by the regulatory agency, and lack of political will.