Health Insurance Scheme In Nigeria
Nigeria has a very large population of over 170 million people. Only 3% of the total population has access to medical insurance. Nigerian is run on a three-tier system government which makes implementation of other policies challenging. The health insurance scheme in Nigeria has met many setbacks as a result of this kind of governance. The health scheme is more defined in urban areas, while rural areas appear to have been left out.
The health insurance scheme in Nigeria dates back in the year 1962 when the Halevi community pushed for its amendment through the Lagos bill. Unfortunately, it was not passed at that time. In 1984, the national council of health under the leadership of Admiral Patrick Koshoni, the then minister of health, introduced a committee which was chaired by Prof. Diejomoah and advised the government on the importance of a desirable health insurance in Nigeria and recommended for its commencement. After many years of different proposals from different health ministers about scheme, it was then officially launched on 15th October 1999 under act 35. Thereafter, an implementation committee was set up to oversee the progress of the programme. It officially became operational in the year 2004.
The national health insurance scheme works under a pre-payment system known as capitation. On a monthly basis, each registered member is given a bill containing the premium they are supposed to pay regardless of them using the NHIS services or not. The amount paid by each member is based on their ability to pay, but when it comes to services being offered, all are treated the same whether you paid less or more than your compatriot. The main aim of the scheme is to eliminate the socio-economic barriers in order to achieve access to health care services easily.
The scheme has faced so many challenges as it continues to develop. These include:
To begin with – the financial cost; many Nigerians live below the poverty line and cannot therefore, afford to enroll into the scheme. Furthermore, rural areas lack the necessary infrastructure and a couple of other challenges result into little penetration.
Secondly, lack of organization by the government to implement the scheme in all states around the country; this is a setback as the NHIS is not mandatory in all states. Another common factor with developing countries like Nigeria and Africa at large is lack of education and awareness on the importance of health care services. These factors have slowed down the development of the health insurance scheme in Nigeria. The government in 2004 announced a plan which was to ensure that all its citizens were under the scheme by 2015. Private and public partners along with community based health insurance are promoting the scheme so that they can achieve a national coverage.