The Federal Government of Nigeria recently made strides in the health sector by passing the National Health Insurance Authority Act 2021, which repeals the National Health Insurance Scheme Act 2014.
The purpose of the Act is to guarantee that a national health insurance policy is effectively implemented, to fast-track the achievement of the universal health coverage in Nigeria.
Stakeholders in the health sector have for decades urged for universal healthcare coverage to be implemented so that it becomes a requirement for all Nigerians, regardless of their position in the formal or informal economy, to be enrolled in any type of prepaid health insurance plan.
This became vital as a result of the fact that 70% of Nigerians end up paying out-of-pocket fees for health care. When individuals are unable to obtain prepaid insurance coverage, they have no choice but to pay for each health care service obtained.
In addition, out-of-pocket expenses are a large contributing factor to Nigeria’s poor health indicators and mortality rates. In a world with limited resources and competing demands for survival, out-of-pocket payments means families have to address their pressing medical needs while still meeting essential requirements such as shelter, food, and education.
Nigeria’s out-of-pocket expenditure is above the global average when compared to countries in sub-Saharan Africa. Rwanda, Kenya, Gabon, Cote D’Ivoire, Burkina Faso, Benin, and Angola, have lesser out-of-pocket expenses than Nigeria.
The average out-of-pocket expenses in Sub-Saharan Africa is 29.98 percent, while Nigeria’s is 70.52 percent. The recently ratified law provides 80 million vulnerable Nigerians, such as persons with disabilities, pregnant women, children, and the elderly with free health insurance cover under the vulnerable group fund.
States may use these funds to develop their own government-mandated state health insurance program. The Act also states that each citizen of Nigeria must have health insurance. Nothing in the S. 14 (2) of the Act would prevent a resident of Nigeria from purchasing private health insurance, as long as they participate in any state-mandated health program. The purpose of this section is to imply that everyone in Nigeria is required by law to have health insurance.
The new legislation should be praised by Nigerians, since it provides a number of advantages. First, beyond cutting out-of-pocket costs, the law will provide a huge mobilisation tool for the health sector. The scarcity of resources in the health sector has been chronic.
For the previous ten years, Nigeria’s health sector budget has fluctuated between 3 and 5 percent of the country’s overall budget. The allocation has remained low considering the significant demands for health infrastructure, supplies, and personnel for primary, secondary, and tertiary healthcare.
The Abuja declaration, which committed 15 percent of the overall budget to health, is also disregarded by the government. Nigeria is once again among countries with the least proportion in sub-Saharan Africa for health spending.
In most countries throughout Sub-Saharan Africa, the minimum proportion for health is 7%, however some African nations set aside 15% of their budgets for health. Prepaid insurance is a pool of money that can be used to finance healthcare investments and acquire crucial health infrastructure, supplies, and personnel.
Furthermore, the new legislation will help the country achieve Sustainable Development Goal 3, which aims to improve health and well-being for everyone regardless of age. It will raise coverage of universal healthcare from its present level of less than 5% of the population to at least 70%.
However, in order for the Health Insurance Authority Act to be effectively carried out, operational guidelines must be swiftly created. All citizens should be covered under any of the prepaid health plans, according to the guideline.
It is important to consider that health insurance identification cards or certificates are required conditions for certain government benefits. Hospitals should be suitably equipped, and medical personnel should be properly trained to ensure that patients’ rights are respected. The installation of professional treatments for citizens would serve as a motivation for Nigerians to sign up for the scheme.
The discussion with stakeholders in the development of health insurance coverage in Sokoto State reveals that residents in the formal sector are ready to participate in the state’s prepaid health plan.
Although the Basic Health Care Provision Fund has been effective in enlisting vulnerable persons into the state’s health insurance program, those who work full time in the formal sector feel neglected.
The Federal Government should collaborate with sub-national governments to make sure that persons who fall under the vulnerable group fund are properly included without neglecting those in the formal sector.
Stakeholders in charge of putting the law into action should be transparent and accountable to the public. To oversee the implementation of the new legislation, civil society organizations should establish an accountability framework.