Tuesday, April 02, 2019 6.00PM / NOI
POlls / Header Image Credit: Guardian
The United Nations and World Health Organization
observe World Health Day on the 7th of April each year and the aim
is to raise awareness of the need to improve global health. The theme for the
2019 World Health Day is “Universal Health: Everyone, Everywhere”. The theme
means that all people have access, without any kind of discrimination, to
comprehensive quality services, wherever they need them, without facing
financial difficulties. It requires the definition and implementation of
policies and actions with a multi-sectoral approach to address the social
determinants of health and promote the commitment of the whole society with
health and well-being. Universal health is not just about ensuring everyone is
covered, but that everyone has access to care when they need it, wherever they
are.
In commemoration of the World Health Day, NOIPolls
presents findings from its past poll on health insurance which was conducted in
August 2017. The poll gauged the perception of Nigerians regarding health
insurance in the country. Findings from the poll revealed that as many as 89
percent of the population pay for healthcare services out-of-pocket. This
finding does not in any way coincide with the main purpose of the National
Health Insurance Scheme (NHIS) which is primarily securing universal health
coverage and access to adequate and affordable healthcare in order to improve
the health status of Nigerians. Further findings from the poll revealed that
only 9 percent claimed they have some form of health insurance, of which 71
percent indicated NHIS and 21 percent indicated Private Health Management Organizations
(HMOs) as their provider. Interestingly, a substantial proportion of Nigerians
(78 percent) who were not covered expressed willingness to pay a small amount
of money monthly/yearly to get enrolled for health coverage.
The chart below showed that the most utilized
healthcare facilities by Nigerians is government owned hospitals (primary,
secondary and tertiary health facilities as revealed by majority of Nigerians
(63 percent) interviewed. This was followed by respondents who visit private
hospitals (39 percent) and Pharmacy/Chemist stores (17 percent), and those who
self-medicate (13 percent) amongst others.
In order to probe further, when asked how they pay for
healthcare services, most of the respondents (82 percent) reported that they
pay “Out of pocket”, and this cuts across gender, geo-political zones and age
groups. Further analysis indicated that a total of 89 percent actually pay out
of pocket, since 7 percent of respondents said they received support from
friends and family, which can also be categorised as out of pocket expenses.
This was followed in a far distance by only 9 percent of the respondents who
claimed that they access health care services using their health insurance
scheme. This finding clearly highlights the low penetration of health insurance
amongst the populace, which urgently needs to be bridged in order to achieve
universal health coverage.
Subsequently, poll also ascertained the willingness of
Nigerians who pay out of pocket to pay a small amount of money monthly or
yearly (premium) in order to access healthcare services when they need it,
especially in time of emergency. In response, 78 percent of the respondents
expressed their willingness to pay a small amount to get enrolled into the
health insurance scheme. Interestingly, during the course of the poll, some
respondents made on the spot inquiries on how to enrol on a health insurance
scheme. These findings clearly demonstrate the critical need for sensitization
and awareness campaigns to mobilize the citizenry on the need and benefits of
health insurance.
In conclusion, contrary to the UN and WHO goal of
ensuring that universal health for everyone everywhere, the poll revealed that
89 percent of Nigerians do not have any form of health insurance, thus they pay
out of pockets to access healthcare services. Of this proportion, 78 percent
expressed their willingness to pay a small amount of money to enable them
access service whenever they fall ill. These findings clearly highlight the low
penetration of health insurance across the country and calls for intensive
sensitization and mass mobilisation of the populace.
It is gratifying that at least 10 Nigerian States have
signed health insurance laws to help in achieving equitable and sustainable health financing mechanism.
Functional State health insurance schemes will help increase the pool of
individuals with health insurance thereby driving down premiums. Finally, while
it is critical for government to re-evaluate its current budgetary allocation
to the health sector; it is also important for stakeholders to consider more
sustainable ways to finance the sector through health insurance, and to
mobilise the public to increase the pool of funds available for investment into
the sector.
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