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Thursday, December 7, 2023

Untold stories: The current state of Nigeria’s National Health Insurance Scheme

The National Health Insurance Scheme was created with the intention of making healthcare more accessible and inexpensive to Nigerians, although this is often not the case.

Who is eligible for National Health Insurance Scheme? 

This programme covers employees in the formal sector (public and the organized private sectors) employment. It is for every organization with ten (10) or more employees and Individual voluntary contributors desiring to access the NHIS Standard Benefit Package. 

Many individuals have died and continue to die as a result of the inefficiency of the system and the personnel who are supposed to carry out their tasks on time. The goal of the programme was to lower registrants’ out-of-pocket expenses.  

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Unfortunately, the majority of registrants continue to pay out-of-pocket expenses as a result of ineffective services provided by health-care practitioners, who are deliberately impoverishing the population. These stories will sound unusual to the wealthy, who can buy a larger health-care package and better hospitals, or who can fly themselves out of the nation on their own dime, or at the expense of the government.  

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For similar reasons, many people have abandoned their health insurance in favour of out-of-pocket payments. Many people who aren’t seriously ill believe that getting quality drugs or treatment from a qualified pharmacy is preferable to wasting time, energy, and transportation to go and queue for poor service from a ‘medical doctor’ at the end of the day. To a lot of folks, that’s the end of it. Remember that whether you go or not, the money collected on your behalf will not be refunded by the health insurance or maintenance companies. Suffering and giggling go on. Our healthcare industry’s narrative.  

Most hospitals will instruct patients to go outside (to stores) and buy medications that they don’t have in stock, even if they have because the patient is an NHIS/HMOs patient. Twenty individuals pass through the door every day, and the tales are all the same. The government has not provided sufficient funding to preserve medications, or NHIS funds were insufficient to purchase the drug. However, they will not tell the patients. Some of them may even recommend a patient to their own private hospitals, pharmacies, or clinics for purchase or further treatment, which is most common in public hospitals.  

Whereas, some hospitals will prescribe the medicines for you to go and buy from any available pharmacy of your choice (out-of-pocket expenses). Going to some private hospitals, you pray and fast to meet the good doctors on duty if not, you take whatever service you get, provided you are using health insurance because low experience doctors are placed on the night, and weekend duties.    

What is the value of the health insurance scheme, when it cannot cover drugs for basic treatment, without going for out-of-pocket expenses? 

The typical Nigerians will not complain, and some who complain will not direct their complaints to the right sources. Some walk away to carter for themselves and their families in places they can get better services. Those that cannot afford are dying in silence.  Then I wonder, whose duty it is to supervise the Nigerian hospitals and the activities of doctors in Nigeria? These took me to the National Health Act, 2014. 

Many Nigerians are not even aware that they have the right to complain if they are not satisfied with the service they received. This is stipulated in the National Health Act, 2014, Section 30(1), which says “A person may lay a complaint about the manner in which he or she was treated at a health establishment and have the complaint investigated”. Again, many Nigerians are skeptical if actually the complaint will be investigated. Again I ask. Even if, will justice prevail? 

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To have a better system, the people in the position of authority should not wait until they received a complaint before they carry out their constitutional functions, especially the highest policy-making body in Nigeria on matters relating to health.   

The National Council on Health comprises the minister of health, who is the chairman; minister of state for health, commissioners for health; and the FCT health secretary and the permanent decretary of the Federal Ministry of Health, who is the secretary to the council, should wake up to their responsibilities. It is important to highlight some of their functions, as stipulated in the National Health Act, 2014. Section 5(1)(a) said they “have responsibility for the protection, promotion, improvement, and maintenance of the health of the citizens of Nigeria, and the formulation of policies and prescription of measures necessary for achieving the responsibilities specified under this paragraph;”. Section 5(1)(c) also said they “ensure the delivery of basic health services to the people of Nigeria and prioritize other health services that may be provided within available resources;”. They are also meant to “issue, and promote adherence to, norms and standards, and provide guidelines on health matters, and any other matter that affects the health status of people” – Section 5(1)(e). 

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If there are no acts, how can Nigerians realize that they have these powers? “Coordinate health services rendered by the Federal Ministry with health services rendered by the States, Local Governments, Wards, and private health care providers, and provide such additional health services as may be necessary to establish a comprehensive national health system,” according to Section 5(1)(j). 

Many Nigerians prefer to die in silence rather than complain and take action, so they lick their wounds. Some people feel that because the system is broken, complaining is pointless, and that some people are unaware of their rights. It is our common obligation to inform them of their rights, particularly when the patient bill of rights is used.    

Nigerians, it is past time for us to understand and demand our rights, particularly when it comes to our health. 

Finally, the system can only function if those in authority are accountable for their actions.  


Chinaza Ogbachalu
Chinaza Ogbachaluhttps://www.chinazaogbachalu.com/
My name is Chinaza Ogbachalu, and I am a writer. I have been writing news and opinion articles for five years plus and have always had a passion for storytelling. I grew up in Nigeria and graduated from the University of Port Harcourt, Nigeria, with a degree in linguistics and communication studies. I have written books that have been well-received by critics and readers alike. My work often focuses on culture and lifestyle, and I draw inspiration from my own experiences and observations of the world around me. As a news writer, I am responsible for researching and writing engaging and accurate news stories for our online audience. I have a strong passion for current events and am skilled at conducting interviews and gathering information from sources. I am grateful for the support of my readers and am constantly humbled by their enthusiasm for my work. Thank you for taking the time to learn more about me and my writing.


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