NHIS enrollees stand at 10.2 million

By Adekunle Yusuf

The total number of enrollees captured so far by the National Health Insurance Scheme (NHIS) now stands at 10,275,144 (ten million, two hundred and seventy-five thousand, one hundred and forty-four), a check by The Nation has revealed.

To achieve equity in healthcare service delivery, health insurance was inaugurated in Nigeria in 2005 – though the NHIS had been decreed into law during the military regime. It was founded with the mandate to achieve universal health coverage (UHC), including financial risk protection, access to quality essential healthcare services, and access to safe, efective, quality, and affordable essential medicines. According to the Act setting it up, the primary goal of NHIS is to improve the health status of Nigerian citizens as a signiûcant co-factor in the national poverty eradication efforts.

Unfortunately, this dream has not become a reality after 15 years. According to Prof. Mohammed Nasir Sambo, NHIS Executive Secretary/CEO, the problem of low enrolment persists because the Act that gave birth to NHIS does not make health insurance mandatory. This has helped to slow down coverage, thus burdening the scheme with multifarious challenges, he stressed.

However, the challenges bedeviling the scheme may not  be here forever, as the current NHIS Act is being amended to make health insurance mandatory for all Nigerians – irrespective of class. Progress recorded on this front included the fact that a new NHIS bill to replace the faulty one has been passed by the Senate, with the bill only waiting to receive concurrence at the House of Representatives and presidential assent before it becomes a law.

Outlining how NHIS intends to capture more Nigerians, he said the scheme is predicating its activities on the three dimensions of UHC: population coverage, service coverage and costs. Because NHIS is a prepayment scheme, Prof Sambo explained that the scheme will increase population coverage by attracting higher levels of funding because more funds will cover more people (demand side). Also on the supply side, the NHIS boss said his team will work with the supply side to ensure that healthcare facilities are available and staffed with adequate human resources.

“The population has to be sensitised and well-educated on the concept of health insurance. They must believe in it before they can enroll. The support of government and spirited individuals and donor agencies are critical elements in expanding coverage,” Sambo said.

Among concrete plans the new management is putting in place to achieve more coverage, he disclosed that NHIS has come up with e-NHIS project to automate NHIS business processes and make enrolment easier. Working closely with the state social health insurance agencies (SSHIAs) under the platform of health insurance under one roof (HIUOR) to improve coverage within the states is another strategy to take the scheme to higher heights, he said, adding the management is leveraging on innovative financing mechanisms such as the Basic Health Care Provision Fund (BHCPF) established by Section11 of the National Health Act to further meet public expectations.

Despite current challenges, the NHIS CEO believes Nigeria can achieve UHC in no distant future, especially if the requisite political will exists, expansion of fiscal space takes place and if all stakeholders collaborate towards making healthcare insurance participation mandatory in the country. By the time Nigeria reaches a stage where everybody enjoys health insurance coverage, Prof Sambo enthused that it would be the dawn of a new era, an era that would gladden the hearts of Nigerians.

Among other things that would happen to the health sector, once out-of-pocket payment fizzles out, he insisted that morbidity and mortality rates in Nigeria will    reduce astronomically, poverty would decline significantly and national productivity would witness massive boost.

“UHC is a continuous process. People will be born and will have to be enrolled. There will also be more focus on quality and expansion of the benefit package. There will be a reduction of morbidity and mortality. Reduction of poverty rate because there is link between poverty and health. Out of pocket spending for healthcare will fizzle out. There will be increase in productivity, as health is wealth,” Sambo said.