Universal Health Insurance Scheme: 17 States Shun It

19 states have different stages of implementing Universal Health Coverages (UHC) through the establishment of health insurance schemes, while 17 states have no plan to join 19 years after the scheme was launched in Nigeria.

Anambra, Delta and Lagos states, in particular, have made significant progress in enrolling individuals on the scheme.

Temitope Falaiye, Head, Medical Services, Leadway Health, at a virtual media training organized by the underwriter in Lagos, said Nigeria spends a small percentage of national income on health, which is about four per cent of the Gross Domestic Product (GDP) as opposed to the 15 per cent said in the 2001 Abuja Declaration. He also stressed that the out-of-pocket expenditure on health, which stands at 77.23 per cent of total expenditure, is about the highest in Nigeria.

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“To bridge the coverage gap, there is a need for states to adopt State Health Insurance Schemes for their workers. 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 Health insurance accounts for less than three per cent of the Nigerian population.”

While he explained that there is no one-size-fits-all approach to achieving UHC as strategies will depend on local circumstances, he also said that improvement requires addressing the building blocks of health systems with a proper roadmap from policy, implementation and monitoring. He listed underfunding and skewed funding allocation in favour of secondary and tertiary care as against primary healthcare as well as poor public financial management as threats to coverage.

“Limited political commitment to health and primary healthcare, poor policy formulation, lack of clarity on roles and responsibilities at different levels of the system, lack of measures to assess the quality of care, lack of confidence in healthcare systems and human resource shortages are among the challenges.”

Regarding the matter of recommendations, he said, “At the onset, we analysed the customer journey, identified pain points and deployed targeted solutions to ensure a best-in-class experience for both health providers and clients. The growth of the company has been exponential with over 51,000 enrollees spread across the country inclusive of corporate, retail and NHIS.”