The Acting Executive Secretary of the National Health Insurance Scheme (NHIS), Dr AbdulRahman Sambo, said inadequate funding was needed to attain universal health coverage in the country.
Sambo told the News Agency of Nigeria (NAN) in Abuja on Sunday that there was the need for special funds to take care of the health needs of vulnerable persons in the country.
He said the scheme had developed key elements to achieving universal health insurance through compulsion for those who could afford health care and subsidy payment.
The subsidy payment, he explained, would ensure that the indigent were taken care of from some of the contributions of those who could afford to pay.
“The major challenge that we have is our law, which makes participation under the health insurance scheme optional, voluntary; number two, the non-logging in of the programmes of the NHIS by states and local governments; these are the two major that has been impeding the NHIS in attaining universal coverage.
“One other major thing that has been clearly defined by us and other stakeholders is the absence of a fund that will provide contribution or pay for the contribution of the vulnerable, the poor, the indigent and those with some forms of disease vulnerability.
“We have identified two key elements that are required to ensure universal coverage, and those elements are compulsion – compelling individuals who have the means to pay for their contribution to do so.
“The second one is the touchy issue of subsidy, we believe that there have to be some subsidy payments for those who can’t afford to make their own contributions.”
Sambo said the NHIS currently covers only 7.5 million Nigerians, adding that the law establishing the scheme was being amended by the National Assembly.
He said it was also important for Nigerians to change their mentality on the notion of health insurance as the advantages out-weighed the disadvantages.
“We currently have covered about 7.5 million persons; the NHIS law is going through amendment in the National Assembly and the amendment will strictly look at making it compulsory and identifying some form of financing mechanism or options to give cover to the poor and the indigent in the society.
“We are going round the country sensitising people, paying advocacy to states governors and local government chairmen, to political leaders, traditional leaders, religious leaders, across the country.
“We are partnering with the media because without the media we cannot be able to reach out to Nigerians; we need to educate Nigerians on the value of health insurance which is a cultural shift.
“Culturally, Nigerians wouldn’t want to pay in advance for their health care; this notion that doing so may connote one’s wish of being ill; this is common in quite a number of cultures across the country.
“People say it is not my portion to get sick. Some think health insurance or insurance in general is against their faith; those are some of the little challenges that we are facing.’’
The acting executive secretary said NHIS was also partnering with the International Finance Corporation (IFC) to reposition the scheme, adding that continuous sensitisation would go a long way to improve the health status of Nigerians.
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“The scheme is being redesigned to ensure that it is well structured to attain universal coverage.
“We are consulting with the International Finance Corporation (IFC); we are actually partnering with the IFC.
“We have engaged the services of a company to look at the NHIS; examine the scheme in four broad areas, policy, regulation and legal framework; that is one area.
“The second area is the business processes of the NHIS; the third area is finance and funding requirement needed to attain universal coverage, and fourthly the IT platform that will be required to move the process forward.
“Sensitisation and advocacy of ordinary Nigerians is a big issue, and that is why we are going round sensitising our partners to assist the scheme in reaching out to Nigerians; let them know the value of health insurance as it’s being done in other countries of the world.
“We have seen countries that are less endowed than Nigeria being able to attain universal coverage within a very short time, largely arising from the political will and commitment of government at various levels in those particular countries to ensure that their citizens are covered.
“This is what we hope to see happen in this country; it’s difficult but it is not impossible. With the support of each person, and those of all stakeholders, we are certain that universal health coverage for Nigerians will be a reality.