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Health experts want informal sector workers enrolled in health insurance scheme


Lagos –  Some health experts on Sunday in Lagos called on government at all levels to develop strategies to enrol the informal sector across the country in the National Health Insurance Scheme (NHIS).

The experts made the call when they spoke with the News Agency of Nigeria (NAN) on the sidelines of a five-day workshop on healthcare financing.

The workshop is organised by the United States Agency for International Development (USAID) Funded Health Finance and Governance (HFG) Project Nigeria in collaboration with the Federal Ministry of Health (FMoH).

Other partners who collaborated are NHIS and the National Primary Health Care Development Agency.

The experts told NAN that the informal sector, including artisans, market women, constituted about 60 to 70 per cent of the economy’s workforce.

Dr Bukola Ayinla, a Health Financing Officer in the Lagos State Ministry of Health, said that getting those in the informal sector into an organised setting was a huge challenge.

“It is easy for countries like the U.K. to capture everybody and bring them under health insurance because they have a database and records of every resident in the country.

“For Nigeria, it is quite difficult because a large number of people who make up the informal sector are still outside the tax net; these include the artisans, market women and commercial motorcyclists otherwise called “Okada’ riders etc.

“It is difficult to get them into an organised setting because such people are afraid of taxation from the government,’’ she said.

According to Ayinla, people in the informal sector cannot be left behind if the country is to achieve Universal Healthcare Coverage (UHC).

She noted that the informal sector also contributed to the health indices of the country.

“If we want our maternal mortality to reduce, if we want our infant mortality to get better, these are the people we really need to reach out to.

“For the organised private sector, some of them have their employers paying for their healthcare services.

“We know that if we do not take care of these people, they will bring down whatever improvement that has been made in the formal sector,’’ Ayinla said.

Another participant, Dr Inyang Asibong, the Commissioner for Health, Cross River State, said there was need for a lot of advocacy and stakeholders’ engagement to achieve health insurance for all.

Asibong said: “Whenever you want to take money from people, no matter how small, it is going to be an issue even if it is for their benefit.

“We have a problem of preventive culture in the country; people prefer to pay for health services when they are ill no matter how expensive, rather than paying little when they are not ill.

“But we need to do a lot of advocacy, explanations and stakeholders’ engagement on why we need to get health insurance kick-started.’’

Mr Lekie Dumnu of Rivers State House of Assembly, and a participant in the workshop, said there was need for collaborative efforts between the government and individuals.

Dumnu, a legislator in the Rivers, said that such collaborative efforts would help to achieve health insurance for many Nigerians.

“This workshop has taught us teamwork and it has also revealed that healthcare financing is a process towards achieving UHC.

“No government can handle it alone, no matter how rich; with the financial situation in the country, it is even more difficult.

“Individuals have to come in and collaborate with government at the federal, state and local levels with the assistance of development partners,’’ he said.

In her remarks, Dr Elaine Baruwa, the Country Manager, USAID funded HFG Project Nigeria, said that there was need to insure vulnerable populations, including pregnant women and under-five-year-old children.

Baruwa identified data on under-five and death of pregnant women in and around giving birth, as the main impediments to the country’s health statistics.

“Ten per cent of all women who die during delivery are Nigerian women.

“This healthcare financing approach is raising money to ensure that the most vulnerable populations are able to access care without paying for it.

“If we can make changes in the under-five mortality, provide pregnant women with healthcare before they give birth and after, then we can make a big difference in the country’s health statistics.

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