By Chioma Obinna
Past President of the Nigerian Medical Association, NMA, and current Vice President of the Commonwealth Medical Association, Dr Osahon Enabulele, has called for a public inquiry, urgent governance reforms and declaration of a state of emergency on the operations and management of the National Health Insurance Scheme, NHIS.
Enabulele who made the call during the 2018 NMA Physicians’ Week in Umuahia Abia State, bemoaned the abysmal level of Universal Health Coverage, UHC in Nigeria, put at 2-3 percent, 19 years after the establishment of the scheme and more than 13 years after the official lunch of the Formal Sector Social Health Insurance Scheme. he said it was time to review its operations.
Enabulele called for an urgent public inquiry, urgent governance reforms and declaration of a state of emergency in the operations and management of the NHIS.
”If Nigeria is to improve on her current poor UHC levels, a holistic and comprehensive overhaul of the National Health Insurance Scheme will have to be urgently conducted, with institution of urgent progressive reforms in the governance and management of the scheme as well as in the mode of appointment of the Executive Secretary and Managers of the Scheme”.
Speaking on the theme: “Universal Health Coverage: Leaving No One Behind” Enabulele said UHC was aimed at ensuring that all Nigerians have access to quality and appropriate health care services whenever they need it without undergoing financial hardship in the course of procuring health care.
He revealed that all the indicators for accessing a country’s progress towards attainment of UHC showed that Nigeria was still lagging very behind, and comparatively doing worse than many less endowed countries like Rwanda, Tanzania, Kenya and Uganda with better UHC coverage levels.
“This poor coverage level has denied Nigeria and most of her citizens several benefits that could accrue from UHC, including improved health outcomes and life expectancy.”
Enabulele identified poor political commitment to health and UHC, poor stewardship role of Government, dysfunctional operational state of the NHIS, Non-mandatory subscription to the NHIS, among others as factors affecting the attainment of UHC in the country.
Stating that the NHIS is Nigeria’s major mechanism for attaining UHC, he regretted that the Scheme has been held hostage, over time, by lots of controversies, poor governance and administrative inefficiency, gross abuse of the selection process for Executive Secretary (ES) of the NHIS, as well as very troubling and recurrent allegations of poor accountability, corruption, executive infractions and misconduct with the resultant ludicrous drama of Ministerial suspension, presidential recall, and the latest indefinite suspension of the scheme’s current Executive Secretary by the NHIS Governing Council.
He called for improved political commitment to health and UHC, strengthening physician-led Primary Health Care and National Health System, amendment of the NHIS Act, curtailing outward medical tourism by political and public office holders, operationalization of the National Health Act among others.
Advancing the need to rid the Scheme of all forms of corruption, vices and infractions, Enabulele called on Government to create an enabling environment for effective supervision and management of the scheme, devoid of undue political interference.