• COVID-19, delayed law slow universal coverage
• Scheme fully back on stream, says NHIS
Coronavirus disease (COVID-19) pandemic and non-passage of the amended National Health Insurance Scheme (NHIS) Act have further slowed uptake of health insurance packages and Universal Health Coverage (UHC) in Nigeria.
More than 170 million Nigerians are still paying out-of-pocket to access medical services, forcing households and individuals to incur catastrophic health expenditure. This can exacerbate the level of poverty, analysts told The Guardian.
Critics worry that the NHIS has remained abysmal and coverage rate dropped, from over 10 per cent (5.6 million Nigerians) 10 years ago, to just barely 1.72 per cent (one million Nigerians) in updated statistics.
A study published in The Lancet, a medical journal, noted that more than ‘‘90 per cent of the Nigerian population were uninsured, despite the NHIS that was established in 2006. Less than five per cent of Nigerians in the formal sector are covered by the NHIS. Only three per cent of people in the informal sector are covered by voluntary private health insurance. Uninsured patients are at the mercy of a non-performing health system.”
Yet, another study showed that only three to five per cent of Nigerians (about 1.7 million and 2.8 million people) are on any form of health insurance.
The National Health Insurance Commission Bill 2019 seeks to address NHIS challenges and also make health insurance mandatory.
The NHIS in Nigeria was launched in 2005 as part of efforts by the Federal Government to achieve UHC with financial risk protection mechanisms.
However, 15 years after the launch of the programme, stakeholders say only about four million Nigerians have any form of health insurance. But the NHIS say over 10 million Nigerians are currently covered under various programmes by the scheme, state agencies and private plans by Health Maintenance Organisations (HMOs).
FORMER President, Pharmaceutical Society of Nigeria (PSN), Olumide Akintayo, told The Guardian: “It remains the same comatose project it has been in the last seven years. What do you expect when the coverage rate drops from over 10 per cent 10 years ago to barely 1.72 per cent which we are left to contend with today. As far back as the era of Femi Thomas, which I think was 2014/15, the enrolment or coverage rate had dropped to 1.72 per cent as far as the NHIS is concerned.
“It is noteworthy to state that there are some private health insurance plans in the organised private sector. These ones are doing well.
“Even the needless and unending amendments of the existing statutes, which has been our portion, has not achieved anything because the ulterior motives of the sponsors of the amendment bills oftentimes override the public interest.”
Akintayo said no state government had a functional health insurance programme. “I cannot give you a figure, but they are less than 10. Lagos State and about five or six others have attempted to commence programmes, but I am not aware they run impactful programmes,” he said.
Akintayo said enrollees on the NHIS had also been affected by lockdowns and all other restrictions imposed by government. He said operations in the pharmaceutical sector could not be optimal from manufacturing to dispensing of drugs because of ban on importation, which affected pharmacists negatively because practitioners were too import-dependent.
MEDICAL Director of Optimal Specialist Hospital, Surulere Lagos, Dr. Ugochukwu Celestine Chukwuneye, told The Guardian that many states were making attempts to have functional health insurance.
“The exact number of Nigerians on health insurance cover is not available but it is generally believed to be below three per cent of the population.”