Why NHIS is not working efficiently in Nigeria – NACA DG

NACA D.G, Sani Aliyu
NACA D.G, Sani Aliyu

The Director of the National Agency for the Control of AIDS, NACA, Sani Aliyu, has stressed the need for the country to go back to the drawing board in the implementation of the National Health Insurance Scheme, NHIS.

He also expressed sadness that the entire budget for health insurance in the UK ‘was bigger than that of Nigeria.’

He said the NHIS in Nigeria was not designed in ‘a ‘progressive way’ and that it should begin by ‘appropriating health care from the vulnerable perspective by making sure the poor get quality care.’

Mr. Aliyu said this in his keynote speech on Thursday at the commencement of a two-day national health dialogue in Abuja.

The establishment of the NHIS came about by the desire of the federal government to better serve the health needs of the population. The scheme made it possible for the insured to seek immediate care whenever there is imminent need to see a physician.

However, the scheme which was set up to ensure financing of health care costs and management for Nigerians through the pooling and judicious use of financial resources to ensure cost burden sharing for patients through pre-payment mechanisms has been enmeshed in several controversies.

Since its establishment 12 years ago, the number of Nigerians covered by the scheme is about 1.5 percent of the population who are mostly civil servants and corporate workers in the private sector.

In his contribution on Thursday, the NACA boss said it was wrong to begin the insurance scheme with the government workers.

Mr. Aliyu while comparing the poor arrangement of Nigeria’s health scheme with that of UK, Ghana and Gabon said taxation plays important role in funding health insurance.

“If it is a voluntary contribution, it is not going to work because it generates often little or nothing.

“The NHIS budget for the UK is more than the entire budget of the Nigerian government and they get this money from various levels of taxation.

“Ghana and Gabon increased taxes on items on luxury goods or health hazard goods such as tobacco.”

Mr. Aliyu said the best plan for NHIS funding is the sustainable source for funds.

He said NHIS needs to be restructured with a new framework.

“Nigeria went down the NHIS route the easiest way and it is time we come back to the drawing board to make it work. We need to create a sustainable funding source.

Mr. Aliyu tasked the government to evolve a strategy that will provide for the vulnerable group.

“Only 1.7 per cent of the country’s population is covered by NHIS. States should come up with plans to key in on health insurance,” Mr. Aliyu added

NHIS deals with two major components; Health Maintenance Organisations, HMOs and Health Service Providers, HSPs.

The NHIS disburses to the HMOs every three months who now pay the health service providers monthly for health services of participants.

Since inception, the HMOs have been paid N351 billion by the federal government. Also, the administrative fee paid to them for the period of 12 years is N60 billion.

Nigerians have complained of its inability to address their health needs. No fewer than 450 petitions have been sent to the National Assembly by frustrated Nigerians.

The complaints ranged from lack of attention by hospitals, delayed attention, low drug dispensing to enrolees in the scheme and sometimes rejection of patients because of the inability of HMOs to meet their payment obligations to hospitals.

Calls for investigation into the activities of the scheme prompted a public hearing on the floor of the House of Representatives a few months ago on the implementation of the NHIS and how the N351 billion was spent.


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