Experts proffer solutions to Nigeria’s dwindling health insurance coverage

A new study conducted by Culture Intelligence from RED indicates that a disproportionate number of Nigerians who own health insurance get it only through their workplace contract.

Even with the country’s 10-year (1946–1956) health developmental plan and a subsequent National Health Insurance Scheme (NHIS) launched by the Federal Government in 2005, the healthcare delivery system in Nigeria has continued to regress rapidly. As of 2018, about 97% of people surveyed by NOIPoll in Nigeria did not have any health insurance and those who owned it mainly had employer-based coverage. To analyse possible changes in the sector, including through the HMOs, Culture Intelligence from RED engaged its 500-member national focus group on the state of health insurance schemes in Nigeria.

Among the participants, who are all between 18 – 45 years and are young urban professionals, about 66% have health insurance coverage while 33.3% do not. Among those who have, 100% secured their health coverage through their workplace contract. The majority of the participants (88.9%) confirmed that they are aware of health insurance schemes and have been engaged by certain brands, and 11.1% claim otherwise. Among those who do not have health insurance, 37% confirmed that they are interested in getting one, 50% say maybe, while 12.5% explained that they are not interested in accessing health insurance.

“By 2021, the expenditure in Nigeria on healthcare is projected to increase overall. The government’s spending on healthcare is forecasted to reach 1,478 billion Nigerian Naira”, said Isime Esene, the chief intelligence officer of RED | For Africa. “The NHIS covers less than 5% of Nigerians in the formal sector, and only 3% in the informal sector are covered by voluntary private health insurance. First, with such high unemployment numbers, it becomes a lot more difficult to access health insurance. Secondly, it appears that more young Nigerians are aware of health insurance schemes, they see the need to own one but still need more information about the options available to them. That is a major reason we still have more than 170 million Nigerians paying out-of-pocket to access medical services”.

“Apart from the evident maladministration and bureaucratic incompetence affecting the NHIS, the scheme has been largely dominated by federal employees so far,” said an expert. “The demand is also low because so many Nigerians are not aware of the scheme, and people who are worried about getting stuck with the drama that comes with everything involving the government.

“Experts have continued to call on the government to make healthcare coverage mandatory in the country. However, HMOs, hospitals, and other stakeholders have to execute the task of engaging those who are uninformed, especially those with limited education, who live below the poverty line and occupy many rural communities”.

A previous study published in The Lancet, a medical journal, noted that more than 90% of the Nigerian population are uninsured, despite the NHIS established in 2006.

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