80% Of Nigerians Pay Out Of Pocket For Healthcare Services, Survey Finds

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Call centre operatives.

A recent survey conducted by NOI Polls has revealed that a staggering 80 per cent of Nigerians pay out of pocket for healthcare services, regardless of the type of healthcare facility they visit.

The survey shed light on the healthcare financing landscape in Nigeria and highlighted the urgent need for improved health insurance coverage in the country.

The chief executive officer of NOI Polls’ legal department, Dr. Chike Nwangwu shared the findings of the public opinion poll during a health financing policy dialogue in Abuja. The dialogue, titled ‘Accelerating the Implementation of the NHIA Act to Improve Health Insurance Coverage in Nigeria,’ was organised by Nigeria Health Watch in collaboration with the National Health Insurance Authority (NHIA).

According to the survey, 58 per cent of respondents stated that they visit public hospitals when they fall ill, indicating a high utilization of public healthcare facilities. Additionally, 36 per cent utilise private healthcare facilities, while five per cent reported using both public and private healthcare facilities.

Shockingly, only 17 per cent of respondents acknowledged having health insurance coverage, suggesting that health insurance uptake in the country remained remarkably low. Among those with health insurance, 75 per cent reported being covered by the National Health Insurance Scheme (NHIS).

Satisfaction with the services provided by health insurance providers was relatively high, with 82 per cent of insured individuals expressing satisfaction, while 18 per cent stated otherwise.

The survey – conducted in the week of November 18, 2022 – also highlighted the critical issue of awareness regarding the NHIS. Only 51 per cent of respondents who pay out of pocket were aware of the NHIS, underscoring the need for increased awareness and education. Interestingly, the poll revealed that 57 per cent of those currently paying out of pocket expressed willingness to pay monthly or yearly to enrol in a health insurance scheme.

The findings of the poll underscored the urgent need for interventions in the Nigerian health system to reduce out-of-pocket health expenditures. With only 17 per cent of the population benefiting from financial risk protection in healthcare, Nigeria falls far behind the benchmark of 90 per cent for an efficient health system. To bridge this gap, stakeholders must undertake a definite and deliberate approach to the mass enrollment of Nigerians into health insurance schemes. Furthermore, intensive sensitization campaigns are crucial, as nearly half of adult Nigerians (49 per cent) disclosed that they are not aware of the NHIS, and 57 per cent of unenrolled individuals expressed willingness to pay for health insurance.

Reducing the reliance on out-of-pocket payments and mitigating catastrophic health expenditures should be prioritised. Achieving this aligns with the vision of the Universal Health Coverage (UHC) Day of 2022, which advocates for a healthy future for all. NOI Polls conducted a public opinion poll to gauge Nigerians’ perspectives on healthcare insurance in the country. The survey, conducted via telephone interviews, involved a representative sample of 1,000 randomly selected phone-owning Nigerians aged 18 and above, covering all six geopolitical regions and 36 states, as well as the Federal Capital Territory (FCT).

The interviews were conducted in five languages: Igbo, Hausa, Yoruba, Pidgin English and English.

Although the survey’s exclusive use of telephone polling may exclude non-phone-owning Nigerians, it is worth noting that Nigeria’s tele density is over 100 per cent according to the Nigerian Communications Commission (NCC). The rigorous scientific process of randomisation and stratification applied in the survey ensured the validity of the findings.

The NOI Polls survey highlighted the significant number of Nigerians who bear the burden of healthcare costs through out-of-pocket payments. To achieve universal healthcare coverage and alleviate financial hardship, expanding health insurance coverage and increasing awareness among the population is crucial.

Racheal Abujah
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