There are indications that only 19 states are at different stages of implementing Universal Health Coverages (UHC) through the establishment of medical health insurance schemes, while 17 states don’t have any plan to affix 19 years after the launch of the scheme in Nigeria.
Anambra, Delta and Lagos states have, particularly, made significant progress in enrollment of people on the scheme.
In a paper, the Head, Medical Services, Leadway Health, Temitope Falaiye, at a virtual media training organised by the underwriter in Lagos, said Nigeria has spent a small proportion of national income, which is about 4 per cent of the Gross Domestic Product (GDP) as against the agreed 15 per cent on the 2001 Abuja Declaration on health.
Stressing that out-of-pocket expenditure on health, which stands at 77.23 per cent of total expenditure, is concerning the highest in Nigeria.
He added that a voluntary National Health Insurance Scheme (NHIS) exists in Nigeria but covers lower than five per cent of the population, adding that Nigeria’s informal economy, which accounts for greater than 60 per cent of its total GDP, is basically uncovered.
“To bridge the coverage gap, there’s a necessity for states to adopt State Health Insurance Schemes for his or her staff. Currently, about 19 states are at various stages of their implementation journey. Anambra, Delta and Lagos States have particularly made significant progress in enrollment. Private Medical health insurance accounts for lower than three per cent of the Nigerian population,” he identified.
Explaining that there is no such thing as a one-size-fits-all approach to achieving UHC as strategies will rely on local circumstances, he said improvement requires addressing constructing blocks of health systems with a correct roadmap from policy, implementation and monitoring.
He listed underfunding and skewed funding allocation in favour of secondary and tertiary care as against primary healthcare in addition to poor public financial management as threats to coverage.
“Limited political commitment to health and first healthcare, poor policy formulation, lack of clarity on roles and responsibilities at different levels of the system, lack of measures to evaluate the standard of care, insecurity in healthcare systems and human resource shortages are among the many challenges,” he said.
On recommendations, he said: “On the onset, we analysed the shopper journey, identified pain points and deployed targeted solutions to make sure a best-in-class experience for each health providers and clients.
“The expansion of the corporate has been exponential with over 51,000 enrollees spread across the country (inclusive of corporate, retail and NHIS.”