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Sunday, January 8, 2012

THE CURRENT STRIDES OF THE NATIONAL HEATH INSURANCE SCHEME

BY CHRISTOPHER IBEKWE

Health Insurance is a social security system that ensures the provision of healthcare to a group of people who make a token contribution on the agreement that they will contribute for Healthcare. Nigeria’s Health Insurance Scheme came fully on stream when it commenced operations in June, 2005. One of the objectives of the scheme is to ensure equitable distribution of Healthcare cost among various income groups. It is also designed to maintain high standard of Healthcare services, and ensure steady flow of funds to the Health sector for development of infrastructure. Six years on, the scheme has recorded significant milestones in the operations of the formal sector Social Health Insurance.

According to the Executive Secretary, Dr. Waziri Dogo-Mohammed, in 2006, the NHIS took off with about 300,000 enrollees, but now has over Four million persons. To ensure easy access to Healthcare, the scheme has accredited over 7,000 Healthcare facilities; comprising primary, secondary and tertiary Healthcare providers, and over 50 Health Maintenance Organizations. It has also addressed the challenge of funding in the Health system by sourcing funds in addition to the normal budgetary provision. The scheme has also developed programmes such as the Tertiary Institutions Health Insurance Programme, meant to provide healthcare for students in Institutions of Higher Learning. In addition, there is the Voluntary Contributors’ Social Health Insurance Programme for the generality of Nigerians who can afford to register on their own and the Retirees Social Health Insurance Programme.

Equally commendable is the implementation of the NHIS/MDG Maternal and Child Health Project, designed to provide free healthcare service to pregnant women and children under five. This programme whose pilot project began in six states of Gombe, Sokoto, Niger, Oyo, Bayelsa and Imo takes care of over a million pregnant women and their children. Currently, the Maternal and Child Health Project has been extended to twelve more states and will eventually spread to the whole country. The NHIS has also succeeded in promoting public private sector partnership in Healthcare delivery. It has further strengthened its operations through the establishment of a central database for effective management as well as the establishment of a National call centre for instant response to enquiries and complaints by enrollees. The scheme has equally fine-tuned a robust IT Platform known as E-NHIS to improve operations and regulation of the scheme while the amended NHIS Act is under-going various legislative processes to make it more relevant to the times. The NHIS has accredited Banks, Insurance Companies, and Insurance Brokers to participate in the implementation of the scheme. The quality of care given to enrollees is adjudged to be consistent with best practices in Health Insurance Industry.
According to studies, over 87% of Nigerians who are benefitting are satisfied with the service of the NHIS. This perhaps attracted some states like Cross- River and Bauchi to join the programme. The success of the scheme has also attracted the interest of private organizations to enroll their workforce. All these achievements have been made possible by the strong support of the Federal Government. However, there are some challenges facing the operations of the NHIS. One of such is the use of the word ‘Insurance” which some Nigerians find uncomfortable due to Religious and socio-cultural considerations. However, the scheme is tackling this through a comprehensive public enlightenment campaign. Others include professional rivalry between some key Healthcare providers and the controversy of the capitation system of payment, as well as in-house dispensing of Drugs from unaccredited Pharmacies. Inspite of these challenges, the NHIS has moved from a scheme that was viewed with cynicism at the beginning to one that has been widely accepted by all.
The ever increasing clamour for the programme is a strong indication of its success and prospects. As the scheme rolls out to the states and the informal sector, through the Community Based Social Health Insurance Programme, the NHIS, adjudged to be the fastest growing Social Health Insurance Scheme in the world is confident of achieving the mandate of universal access to Healthcare in Nigeria by 2015.

Source: FRCN daily commentary

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