Why NHIS performance is poor in Nigeria – Executive Secretary

Medical Doctors (health workers) attending to patients used to illustrate the story health
Doctors attending to patients used to illustrate the story

The Executive Secretary of the National Health Insurance Scheme (NHIS), Mohammed Sambo, on Wednesday outlined the factors behind poor service delivery by the scheme since its inception.

He promised through his administration’s “rebranding agenda” to reform and transition the scheme to a result-oriented ‘new NHIS’.

The NHIS commenced in 2005 to help Nigerians tackle expensive out-of-pocket health spendings. However, the scheme has not lived up to that expectation as it is yet to cover a majority of Nigerians.

Presenting a paper, “NHIS Changing Landscape”, at a strategic meeting with NHIS enrollees in the formal sector, Mr Sambo mentioned the establishing Act of the scheme as chief among the causes of the challenges bedevilling the scheme.

He said the Act makes the scheme non-mandatory, thereby causing minimal coverage. “If it (Act) was made compulsory, by now we will not only be talking about maximum coverage but also high-quality service delivery.”

The executive secretary also noted that the Act mainly focused on the formal sector. “There is no way you can achieve Universal Health Coverage (UHC) without involving the informal sector”, the official noted.

His comment reiterated concerns repeatedly raised by players in the health sector on the need to amend the NHIS Act to make the scheme compulsory for all.

A bill to repeal and replace the NHIS Act was passed by the 8th National Assembly in April and forwarded to President Muhammadu Buhari. But he has neither signed it nor declined assent.

Mr Sambo, a professor, also said the internal leadership rancour in the NHIS is another factor for its failure.

He said NHIS has had a high turnover of Executive Secretaries due to internal crisis. “Since inception, there have been 12 Executive Secretaries. If there is no stability, the scheme will not work. The internal crisis resulted in weak program implementation and the enrollees are facing the brunt.”

‘Rebranding Agenda’

The official assured enrollees that his three-point rebranding agenda aims to address the myriad of challenges the scheme is facing.

They are: Restoring a value system that will transform NHIS into a result-driven agency; engendering transparency and accountability in the entire operation of the scheme, and accelerating the drive towards achieving universal access to quality health care for all Nigerians.

Mr Sambo alluded to challenges enrollees face in the quest to get quality health services.

In 2017, enrollees sent no fewer than 450 petitions to the National Assembly.

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

The executive secretary urged enrollees at the event to “feel free to share their experiences, challenges and possible solutions to them”.

He said the rebranding agenda is engineered to interface with several stakeholders in the NHIS with the aim of identifying all the challenges that will be followed with result-driven solutions.

“This is why I want this meeting to be as interactive as possible because we can no longer sit in our office and generate solutions for uniformed problems.”

He said his administration was working towards providing a “water-tight enrollee system” through a transparent and systematic Information and Communication Technology (ICT).

Held in Abuja, Wednesday’s retreat with enrollees is a continuation of Mr Sambo’s rebranding agenda kick-started upon his assumption of office about a month ago.

It is coming barely two weeks after the NHIS management retreat was held in Kaduna.

Mr Sambo was appointed as substantive head of the NHIS after his predecessor, Yusuf Usman, was sacked for alleged fraud and misconduct.

A few days after his appointment, PREMIUM TIMES enumerated six urgent steps the new NHIS scribe must take to break the jinx of leadership crisis and get the scheme up and running.

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