Access to Prepaid Health Care for Nigerians by 2030
The World Bank projects that over 92.6 million Nigerians will be living in poverty by 2022. This reality underscores a vicious cycle where poverty exacerbates health issues, which in turn deepens poverty. Addressing these intertwined challenges is crucial for improving public health.
Barriers to Health Care Access
Poverty remains a significant obstacle to obtaining health care for many Nigerians. Therefore, proactive measures are essential to counteract the projections put forth by international finance organizations. The commitment of the National Health Insurance System (NHIS) to mitigating this issue is pivotal in providing an avenue for all Nigerians to avoid the burden of out-of-pocket health care expenses.
Goal of Universal Health Coverage
The primary aim is to foster an environment where every Nigerian can access preventive, promotive, rehabilitative, and therapeutic health services without financial strain. This vision aligns with the broader goal of Universal Health Coverage (UHC), which the NHIS strives to achieve by 2030, in accordance with the United Nations Sustainable Development Goals (SDGs).
Framework for Vulnerable Populations
According to this timeline, the NHIS anticipates that 90% of Nigerians will gain access to prepaid, risk-pooled health care systems. Furthermore, its objective is to ensure that all vulnerable populations receive support through social assistance and safety nets. Ideally, out-of-pocket expenses should not exceed 30% of total medical costs.
Challenges in Achieving Universal Health Coverage
While efforts are underway, gaps in achieving UHC have been identified by the NHIS and its partners. Professor Mohamed Nasir Sambo, Executive Director of NHIS, has highlighted these challenges in discussions with various stakeholders. Central questions include the current health insurance penetration among Nigerians, which segments remain uncovered, and strategies for including these vulnerable groups.
Legal Reforms to Support Health Insurance
To tackle these pressing challenges, a thorough review of the NHIS Act No. 35 of 1999 is underway, aimed at mandating universal health insurance for all Nigerians. The Executive Branch recognizes the crucial need to eliminate discretionary clauses within the Act and is actively engaging key parliamentary figures to drive necessary legal reforms. Positive progress has been made, with the amended NHIS Act recently passing Congress and now awaiting presidential approval.
Decentralization of Health Insurance Implementation
In a shift from previous approaches that overlooked state-specific roles in health insurance, the NHIS is now advocating for decentralization policies to enhance efforts toward UHC. Following a resolution from the Emergency National Health Council in March 2016, several states, including the Federal Capital Territory, have established social and health insurance agencies, with NHIS offering essential support and guidance.
Investment in Health Infrastructure and Community Outreach
The enactment of the National Health Act, which includes the Basic Health Care Provision Fund (BHCPF), represents a significant advance toward achieving comprehensive health care access. As a key implementing agency, NHIS supervises funding and procurement for primary health centers nationwide, thereby enhancing health infrastructure in underserved areas. Plans to recruit Community Health Extension Workers (CHEWs) further aim to meet healthcare demands.
Innovative Health Insurance Programs
Under the leadership of Professor Sambo, NHIS is implementing a series of initiatives focused on transparency, accountability, and universal health access. Programs such as the Catastrophic Cancer Fund, Compensation for Members of the National Youth Service Corps, and the National Compensation Scheme for the Elderly and Retirees are currently in progress. The newly launched Group, Individual, and Family Social Health Insurance Program (GIFSHIP) is designed to cover those without formal sector insurance, including small businesses, self-employed individuals, and diaspora groups.
Aiming for a Healthier Future
The GIFSHIP initiative allows beneficiaries to access a range of health services at competitive rates, marking a significant step toward comprehensive health coverage for all Nigerians. With continued efforts inspired by NHIS leadership, the nation is on a promising path toward achieving Universal Health Coverage by 2030. The overarching goal remains to reduce poverty rates while ensuring that no Nigerian is left without access to essential health services.
*Emmanuel Ononokpono is the Deputy Director and Head of Media and Public Relations at NHIS.
