Health insurance in Nigeria and its challenges

By
Healthfacts.ng
-

Access to proper healthcare in Nigeria is unattainable for most Nigerians. Why is that you may ask? Well, for one, healthcare is expensive. To be fair, it is expensive everywhere in the world. But many developed countries of the world run an effective health insurance scheme.

Now, you may say that health insurance is not so perfect in many developed countries. At least not as they would have you believe. That is a true observation, but at the same time, at its heart, health insurance is an important part of the health infrastructure of any country. And those countries get it right, at least right enough for it to matter.

Health Insurance is a mechanism through which governments protect their citizens from the high costs of good healthcare. This healthcare subsidy is important because, without it, many will not have access to proper healthcare.

Also, according to the WHO and the World Bank. An estimated 100 million people worldwide become very poor because of the high cost of healthcare. If health insurance is this important, how then has Nigeria made it work for its citizens?

How to improve Health Insurance in Nigeria

Healthcare insurance in Nigeria has been around for about 15 years. There has been no commensurate improvement in uptake though. As at 2016, only 3% of total healthcare expenditure in the country was paid for by health insurance.

That number has not improved much in the intervening years. This will only happen when some things are put in place. Keep reading to find out what they are:

1. Effective funding

There are different types of health insurance schemes. Whatever the type though, there is always a need for sustainability. And this happens only when the scheme is able to attract premium payments. These large-sum premium payments from the few makes it possible for the scheme to help others that can’t afford it.


In Nigeria, donor funding is important in keeping the lights on when it comes to Healthcare Insurance. These funds are sourced from foreign governments, international aid agencies, and other organizations.


High net-worth individuals also do their part here, infusing funds into these schemes. Most times, these monies are used to target specific healthcare issues. Issues like HIV/AIDS, tuberculosis, malaria, polio, and others. The pertinent question here, though, is – are these funds effective and are they improving our healthcare?

Fraud Prevention

As is true with probably every human endeavor that involves money, there is always the possibility of fraud. In a bulletin by the WHO, it was reported that globally, about 7.29% of healthcare funds have been lost to fraud.

Nigeria is not left out here. Healthcare insurance providers refusing to pay claims from hospitals. Hospitals declaring bogus services rendered to get more money from healthcare providers. These are all obstacles to making the system work.

To fix this, integrating information systems and automating processes will go a long way. This is true in a country like Nigeria with limited use of IT systems and processes. At least compared to other countries with a good Health Insurance system.

Who will bell the cat?

It is obvious that for the Nigerian National Health Insurance Scheme to be truly effective, some work needs to be done. By the government, by the stakeholders in the business, and even by the average Nigerian. But then, who will take the first step?

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