While the UHC mandate for Nigeria aims to ensure up that 30 percent of Nigerians have some form of
health cover by 2015, the country is yet to attain 10 percent coverage ten years after former President [pro_ad_display_adzone id=”10″]Olusegun Obasanjo launched the National Health Insurance Scheme (NHIS).
Among other things, the insurance scheme is aimed at ensuring that every Nigerian has access to good health care services, equitable distribution of healthcare costs among different income groups and ensure high standard of healthcare delivery to Nigerians.
Prof. Eyitayo Lambo, former minister of health, said though he was mandated while as minister by [pro_ad_display_adzone id=”10″]former President Obasanjo to ensure coverage by 2015, the challenges were enormous. He advised that lessons from Ghana and Ethiopia’s health financing model should be [pro_ad_display_adzone id=”10″]critically examined so that Nigeria could adopt best practices in its health insurance scheme.
According to Prof. Lambo: “To get to the promised land of universal coverage, certain things need to be done. The commitment should not only come from the federal but the states as well and until we get that, we cannot get to the Promised Land. We are 10 years after the launch of the formal programme, and where we are now is certainly below 10 percent coverage. That means we have a long way to go. We should spend the next two days of the summit getting ideas on how we can refine it.”
Currently, bottlenecks ranging from misconception among healthcare providers, Health Maintenance Organisation (HMO) and patient, current NHIS Act, lack of awareness and innovative products have prevented the industry’s development with a minimum paid-up share capital of over N29 billion.
Mr. Lekan Ewenla, Managing Director/CEO, Ultimate Health HMO, revealed that innovation is pivotal in driving health insurance business and not a one-product-fit for enrolees.
According to Ewenla “A product designed for security personnel cannot be the same for market sellers. Each health insurance product should take into consideration their disease pattern and healthcare need. Remember that the population is dynamic with the informal sector yet to be fully harnessed by industry players.”
“The regulator (NHIS) has a great role to play in the operation of managed care as experiences in other nations have confirmed but such role should be limited to regulation and provision of the enabling environment. There should be clear defined roles and responsibilities for the players (HMOs) and the regulator (NHIS). For instance, if the regulator’s role is to regulate, she has no business to design products for enrolles.”
Currently, about 7 in 10 Nigerians access healthcare through high out-of pocket payment for health, a situation that pushes them into poverty. This coincides with NOI, a polling and research organisation, which recently revealed that 8 in 10 Nigerians (79 percent) do not have access to health insurance, a development that shows huge market for Health Maintenance Organisation (HMOs) in Nigeria.
A cursory look at managed healthcare shows that the England’s National Health Scheme is universal and covers every resident of the country. It is largely paid for by tax but cost the government £120billion in 2013.
Ethiopia operates a health insurance that’s hugely community-based but targeting formal sector workers and pensioners in more than 130 districts of the country. On the other hand, Ghana is still expanding benefit package in its health insurance but it is funded through social security and value added taxation—2.5 percent in health insurance fund and another 2.5 percent in social security contribution.
Experts have advised Nigeria to adopt minimal benefit package for health insurance and then seek to expand it time.
Nigeria is still faced with the challenge of financing health for its population, ensuring patients have physical access to hospitals when needed, and an inadequate participation of the private sector in health care.
Experts’ meeting dwelt on two major areas; considering targets to ensure all households have at least one health facility within a five-kilometre radius, and developing an effective referral system.
Nigeria’s health insurance is still voluntary but new legislation is underway to mandate employers to buy health cover for their employees. In addition, Nigeria’s health insurance scheme is hoping to open to more populations aside the organised workforce.