The National Health Insurance Authority (NHIA) has achieved a significant milestone with 19.2 million Nigerians now enrolled in health insurance schemes.
This marks a 14% increase from the previous figure of 16.7 million. The growth is a critical step towards achieving the NHIA’s goal of 20% additional enrollment by 2025 as part of its commitment to universal health coverage (UHC).
The NHIA revealed that 2.4 million enrollees are vulnerable Nigerians supported under the Basic Healthcare Provision Fund (BHCPF). The agency’s Director General, Kelechi Ohiri, noted this achievement underscores its dedication to ensuring equitable healthcare access for all Nigerians.
“We are proud to announce that 19.2 million Nigerians have been covered by health insurance. This surpasses our 2024 target and places us within striking distance of achieving 95% of the 2027 presidential target,” said Ohiri.
Despite this progress, Nigeria’s health insurance landscape remains fragmented, comprising 83 private insurers and 37 state health insurance agencies. The DG acknowledged that this disjointed system presents challenges to creating a unified and efficient healthcare framework.
He stressed the importance of public trust:
“Trust is crucial. Nigerians need to know that being insured guarantees access to care.”
To address these issues, the NHIA aims to enhance regulatory compliance, foster collaboration among stakeholders, and improve public awareness about health insurance benefits.
Key Initiatives Driving Progress
The NHIA attributed its successes to partnerships with state health insurance schemes and various stakeholders. Some of the notable initiatives include:
- Fistula Care Program: This program provides free treatment for women suffering from obstetric fistula, a condition resulting from prolonged childbirth complications.
- Saving One Million Lives (SIGOP) Program: Designed to reduce maternal deaths by eliminating financial barriers during emergencies.
- Comprehensive Emergency Obstetric and Newborn Care (CEmONC): Expanded access to CEmONC services in over 100 healthcare facilities nationwide, improving maternal and neonatal healthcare delivery.
Ohiri emphasized the NHIA’s commitment to removing financial constraints during emergencies:
“When women face life-threatening obstetric complications, financial constraints must not hinder their survival. We waive costs to ensure immediate care and subsequent enrollment into health insurance.”
To tackle rising medical costs and maintain service quality, the NHIA has implemented several financial reforms:
- Increased capitation rates by 60%.
- Raised professional fees by 40%.
- Commenced actuarial studies to align health insurance premiums with industry standards.
These measures aim to make health insurance more viable for providers and beneficiaries, ensuring the sustainability of the system.
Ambitious 2025 Targets
The NHIA has set its sights on several ambitious goals for 2025, including:
- Achieving a 20% increase in health insurance enrollment.
- Expanding access to CEmONC services nationwide.
- Partnering with the National Pension Commission (PenCom) to provide health insurance for retirees.
- Launching a fully digital platform to streamline enrollment, claims submission, and complaint management.
- Digital Transformation
The introduction of a digital platform is expected to improve efficiency and user experience. This platform will allow seamless enrollment processes, facilitate claims submissions, and enhance complaint resolution mechanisms.
Complaint Management and Enforcement
Between January and October 2024, the NHIA received 2,591 complaints, of which 1,678 were against healthcare providers, and 913 targeted the NHIA itself.
The agency achieved an 82% resolution rate, attributed to a decentralized complaint-handling system operating at state levels.
Acting Director of Enforcement, Habib Abdulhameed, highlighted the agency’s focus on compliance:
“In 2024, we sanctioned a total of 100 healthcare providers for various infractions, including warnings, fines, and suspensions.”
The NHIA remains committed to creating a healthcare system where every Nigerian, regardless of socioeconomic status, has access to quality healthcare. Ohiri summarized the agency’s vision:
“We are not just building a scheme; we are redefining healthcare delivery in Nigeria.”
Through continued collaborations, innovative programs, and a focus on trust and transparency, the NHIA is paving the way for a more inclusive and efficient health insurance system in Nigeria.
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