Over the years, the need to always dip into your pocket or reach for your chequebook or passbook at the point of access to healthcare, has effectively denied access to even the most basic healthcare services especially for the masses, thus restricting any potential for economic productivity and diminishing the impact of social welfare.
For decades, out-of-pocket payment has been the Achilles’ Heel of access of healthcare services in Nigeria. Financial incapability is one barrier that tends to classify the delivery and uptake of essential healthcare services as a “luxury” that is restricted from all but a handful of Nigerians with deep pockets. But nowadays, even those blessed with deep pockets have come to realise their pockets may not be deep enough to sustain such payment indefinitely.
If pointers from the National Health Insurance Scheme, NHIS, are anything to go by, the out-of-pocket payment phenomenon is set to end for good. Nigerian masses that constitute about 70 percent of the populace, can now heave a sigh of relief as access to comparatively adequate health services may be no farther away than a phone call or text message.
Prior to this development, news gained ground within the nation’s teeming populace that healthcare is not for the poor – a perception the official launch of the Formal Sector Social Health Insurance Programme did little to assuage.
Introduced as a social health security system strictly for employees in the formal sector, the Programme is financed from funds created through pooling of contributions of employees and employers.
Arguments have been put forward in various circles that Nigerians outside the public sector, or the Organised Private Sector, are not covered under this health insurance programme.
Removing financial barriers
So in attempting to balance the odds and guarantee Universal Health Coverage, the NHIS is removing financial barriers. Explaining the strategy, Executive Secretary of the NHIS, Dr Femi Thomas, explains that the NHIS is saddled with “responsibility to remove financial barriers and at the same time ensure quality through accreditation, reaccreditation and visitation.”
Guided by emergence of Universal Health Coverage, UHC, as a new global objective set for all nations by the World Health Organisation, WHO, towards enhancing the economic prosperity and social well-being of humanity, Thomas who gave his score card for the last year, said the conceptualisation and development of new initiatives with the potential to help frog-leap health insurance coverage in Nigeria.
National Mobile Health Insurance Programme
Designed to strategically increase health insurance penetration particularly in the hard-to-reach areas of the country, the National Mobile Health Insurance Programme, NMHIP, a novel concept, and first of its kind anywhere in the world, provides a platform for subscribers of mobile network operators to register on the Scheme, select an HMO and provider, choose payment options and plans, at their convenience on their mobile phone.
“The pilot run for this was launched in Lagos on the 21st of July, 2014, on the platform of MTN, while network operators, including Glo, Etisalat and Airtel are waiting in the wings for roll out, as soon as President Goodluck Jonathan officially launches the programme. “Its weaknesses and advantages are being studied. When fully launched, it is expected to give coverage to no less than 20 million lives on that platform,” Thomas stated.
An outstanding component of the Mobile Health Insurance Programme is the Adoption Tree. On this platform, well to do and well-endowed individuals and corporate bodies with the spirit of charity contribute to a pool of funds from which the poor and the vulnerable will enjoy health insurance coverage. There is the Specific Adoption in which the donor specifies who he wants coverage provided for, and the Non-specific platform that could provide care for any set of deserving beneficiaries.
Public Primary Pupils, Health Insurance Prog
Also on hand is the Public Primary Pupils Social Health Insurance Programme, PPPSHIP, designed to provide cover for about 24 million pupils of public primary schools nationwide. To accomplish this, the NHIS is bearing responsibility for the programme in the rest of the year, while by 2015, state governments will absorb 60 percent of the cost of implementation, with NHIS bringing up the balance of 40 percent. Already, 20 states have made provision for this activity in their 2015 budget.
Tertiary Institutions Social Health Insurance
Debuting as a very cheap programme specifically designed for those in the tertiary institutions nationwide, the Tertiary Institutions Social Health Insurance Programme, TISHIP, with a restructured and revised blueprint has potential to add three million lives. About 900, 000 are currently covered under the programme.
According to Thomas, “All they need is N2,000 per year to be covered while in school and during the holidays. It also covers two live deliveries for the ladies while in school so there will be no case of dropping out of school. Already, the National Universities Commission, NUC, has directed all public and private universities to participate in the programme as a matter of policy even as the National Board for Technical Education, NBTE, and the Nursing and Midwifery Council of Nigeria are set to key in Community-Based Social Health Insurance Also thriving is the Scheme’s flagship programme in the informal sector, the Community-Based Social Health Insurance has been thriving and various communities around the country are set to flag off of their home-grown CBSHIP programmes. In the last one year, CBSHIP programmes in Emoriko and Egbe in Kogi state, Nkana West Ward II of Akwa Ibom state and Lamodi-Offa in Kwara state have been inaugurated.
Within the last one year, enrolment figure has gone up by about two million lives, about 40 percent of total figure for the preceding eight years. As at today, total enrolment figure stands at about 7.2 million lives. The NHIS appears firmly on ground as the major hub for attainment of Universal Health Coverage by 2020, even as the accomplishment of the target of 40 percent coverage by 2015 remains in sight.