About 14.6% of Nigerians are unable to access adult medical services while 11.7% are unable to access child healthcare services. Another 9.5% cannot access maternal health care services.
This lack of access has been blamed in part on the cost of accessing healthcare which has been said to be unaffordable. Nigeria has one of the highest rates of out-of-pocket healthcare. Funding has also been identified as part of the challenges facing the Nigerian health sector, with Nigeria consistently failing to reach the benchmark of 15% of total budgetary allocation on healthcare.
Health Insurance Schemes in Nigeria
The National Health Insurance Scheme was created to ensure that Nigerians get healthcare at an affordable rate. The scheme allows its participants to pre-pay a regular amount. These amounts are pooled to ensure that health maintenance organizations who run the scheme have the benefit of adequate financial strengths to provide medical services.
Employees under an organization can also benefit from the scheme and as an individual, family, or group under the scheme.
The paid amount covers the cost for the team member, spouse, and four children under the age of eighteen.
The scheme also has a special provision for physically challenged, prison inmates, pregnant women and the aged.
Umar, spokesperson of the National Health Insurance Scheme revealed that it cost 45,000 per year for an individual to register for the scheme. Also, a group of 10 persons will pay N150,000 as the amount per annum to benefit from the program while it would cost a family of four N60,000 per year to benefit from the health insurance scheme.
Explained further, it would mean that an individual can enjoy adequate healthcare for N3,750 per month or the yearly contribution of N45,000. A family will pay an amount equal to N5,000 monthly for healthcare for four family members. While a group of ten persons paying N150,000 per year equates to N15,000 per person per year. This equates to N1,250 monthly.
The program is also run through health maintenance organizations located in different parts of the country.
The NHIS has faced several criticisms, from the inadequacy of its coverage to the speed of payments to service providers and several corruption scandals. However, it does provide cover for basic services and is better than paying out-of-pocket healthcare expenses which has led to loss of lives especially in cases where patients of their caregivers cannot pay for the health service needed.
Some states in the country have also launched health insurance schemes. For instance, Lagos state in 2007 launched a community-based health insurance scheme. The program is essentially a partnership between the state and the private sector. The scheme subsidizes the healthcare amount payable.
The scheme utilizes the Primary Healthcare Centres in Local Governments and provides maintenance services for the facility and security, ensure the availability of an ambulance for emergency services as well as assist in monitoring to ensure no interference or disruption of the services rendered by the provider.
The Private Health Care Provider staffs and manages the health facility, providing drugs and consumables, and offering prepaid primary health care services to registered enrollees.
In Ogun state, there is a health insurance agency responsible for ensuring that residents of the state have access to quality healthcare without facing undue financial hardship. The Ogun state health insurance scheme is set to officially kick off on February 3rd, 2022.
In Kaduna, there is the Kaduna state contributory health management scheme, with a mandate to ensure universal health coverage in the state.
Some of the services rendered by the scheme includes, maternity care, prescribed emergency drugs care, radiology, diagnostic lab test, and instant services.
The coordinator of the Jigawa state national health insurance scheme, Bala Mohammed, told Dataphyte that the scheme has existed for fifteen years and is able to accommodate as many persons that want coverage with no limitations.
Although there have been reports on the inadequacy of these schemes in tackling Nigeria’s health sector challenges, the schemes may still be ways to make healthcare accessible to many Nigerians especially in rural areas. The schemes can do with increased awareness and resolution of identified challenges such as funding, coordination, policy frameworks etc. to turn around the under-performance nationally and in different states.
Working health insurance schemes are necessary for the country to achieve Sustainable Development Goal 3.