‘Nigeria can achieve universal coverage if health insurance is made mandatory’

Executive Secretary of the National Health Insurance Scheme (NHIS), Prof Mohammed Sambo has said that the only way Nigeria can attain Universal Health Coverage (UHC) is to make health insurance compulsory for all Nigerians

Sambo who observed that NHIS is operating a 2004 law, which is solely focused on the formal sector, argued that even if the NHIS is performing at its best, it wouldn’t have covered more than the people in the formal sector in Nigeria.

Speaking at a two-day workshop organized by the agency for State Social Health Insurance Scheme and other stakeholders, the Executive Secretary said that all the monies coming to the NHIS is from contributions from the salary of the public sector workers, noting that the NHIS Act is undergoing review to make health insurance mandatory for all.

He said, “For now, health insurance is not mandatory, even if the NHIS is working at it’s best. But if it is made mandatory, it therefore means that they will make contribution to the pool of the national insurance scheme then you have a large pool. When you have such a large pool of fund, you do what is called cross-subsidisation. The rich will subsidise the poor, and there is a tendency you will have a surplus fund with which you will use to give and create subsidy for those who cannot pay. Under the mandatory insurance scheme everybody will join and then you have the money coming from the public sector, from the private sector and you have contributions coming from persons that are rich. With that kind of funding, you can now begin the journey towards achieving universal health coverage”.

The NHIS boss explained that with the decentralisation of the Scheme, most of the states have created their social health insurance agencies stressing that the retreat was to bring all the actors under the health insurance scheme together to create a platform that will enable us move towards Universal Health Coverage (UHC). Information about health insurance scheme is very poor.

According to him, “This workshop is trying to bring about all the stakeholders – the national and state health insurance scheme under the platform that we have created, and will be called ‘Health Insurance Under one Roof’. Under this situation, we will have very good central coordinating system whereby we can get aggregate of all the numbers of enrollees that have joined the NHIS in Nigeria. This way we know those who are statutorily covered under the formal sector, and the segment of the population that is not yet covered, and who is supposed to cover that segment – federal or state government. At the end of this retreat, we will develop a matrix of cover.”

He added that NHIS has disbursed monies from the Basic Health Care Provision Fund (BHCPF) to 17 states, so that the states will now identify the vulnerable segment of the population and cover them with the fund.

Also speaking, the Executive Secretary of the Osun Health Insurance Agency and the Chairman of Forum of Chief Executives Officers of State Insurance agencies, Dr. Niyi Oginni, said that government is considering having health insurance operate under one roof adding that this became necessary due to the various fragmentation, lack of coordination and operational disunity in the health insurance industry.

According to him, “The NHIS, state health insurance, private health care providers and others are all doing different things and there is no coordination. As a result, there is no mechanism to provide accurate data of the number of people covered by health insurance in the country because there is no interoperability. Want to come up with a framework that will bring everybody under one roof in terms of coordination of Health insurance activities in the country, exchange of data, having seamless Information Communication Technology (ICT) structure at both national and state insurance agencies. He observed that with the health insurance under one roof, there will be a more coordinated manner of enrollment process that will eliminate multiple enrollment and the data can be captured into the National data base with better service delivery.