NHIA Chief Reflects On Advancements, Challenges Of Insurance In Nigeria

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The director-general, National Health Insurance Authority, Dr. Kelechi Ohiri.
The director-general, National Health Insurance Authority, Dr. Kelechi Ohiri.

The director-general of the National Health Insurance Authority (NHIA), Dr. Kelechi Ohiri assessed the advancements and persisting challenges of Nigeria’s health insurance scheme since its establishment in 1999.

Despite notable progress, significant issues like low coverage, uneven distribution and persistent quality concerns continue to hamper the scheme’s effectiveness.

Speaking on Friday in Abuja at the NHIA’s Strategic Stakeholders Engagement in collaboration with the Nigeria Universal Health Coverage Forum and the Local Health System Sustainability Project (LHSS) – Project Nigeria, Ohiri pointed out that the NHIA Act was enacted on May 19, 2022. This new law repealed the NHIS Act of 2004, addressing some issues of the previous law by mandating health insurance and setting up the Vulnerable Group Fund. The Act also transforms the NHIA into a promoter, integrator and regulator of all health insurance schemes in Nigeria.

Aligned with the aim of achieving Universal Health Coverage (UHC) in Nigeria, the NHIA, alongside the Nigeria UHC Forum and the United States Agency for International Development (USAID) – LHSS, focused on “The NHIA Act: Two Years After – Reflections and Future Direction” to review the past, evaluate the current state, and share a common vision for the future of health insurance in Nigeria.

Ohiri emphasised the significant changes brought about by the NHIA Act 2020, which mandates health insurance for all Nigerians, establishes state-specific schemes, creates a vulnerable group fund, and enhances the NHIA’s regulatory capabilities. While mentioning that 62 per cent of the formal public and private sectors are covered, he highlighted that only 1 per cent of the vast informal sector is currently covered. Expanding access to this sector and vulnerable demographics remains a crucial objective.

Outlining NHIA’s vision to achieve universal health coverage, Ohiri emphasised enforcing mandatory insurance, increasing public awareness and trust in the system, enhancing quality standards and market efficiency and activating funds earmarked for vulnerable groups. He reiterated NHIA’s pledge to transparency, setting stringent standards and regulating the diverse health insurance landscape, stressing that achieving these goals necessitates collective effort from all stakeholders.

Calling for regular interactive stakeholder engagements, Ohiri emphasised the importance of addressing challenges in Nigeria’s health insurance sector through continual dialogue and collaboration. Chief of Party at LHSS, Dr. Bolanle Olusola-Faleye highlighted the opportunity for essential investments in Nigeria’s Health Sector Renewal Initiative to ensure financial risk protection for the underprivileged and vulnerable populations.

The NHIA strategic stakeholders’ engagement included a panel discussion moderated by director of DGI Consult Limited, Gafar Alawode featuring representatives from health maintenance organisations (HMOs), state health insurance schemes and civil society organisations (CSOs). Alawode mentioned that the panel aimed to promote collaboration to expand coverage in alignment with NHIA’s health insurance vision for Nigeria.

Dr. Elaine Baruwa stressed that enrollment is a crucial step towards realising tangible health benefits. She advocated for a compelling business case for health investments that resonate with financial decision-makers. A health economist at WHO Nigeria, Dr. Francis Ukwuije emphasised the importance of prioritising data on key health insurance programme outputs to facilitate informed decision-making.

Chairman of the Health System Reform Coalition of Nigeria (HSRCN), Dr. Mustapha Lecky highlighted the coalition’s readiness for effective collaborations to fulfill their mandates. Lecky emphasised the importance of collaboration, partnerships, support, planning and a strategic approach within the coalition, calling for enhanced engagement of CSOs to drive advocacy and progress under the NHIA Act.

The Minister of Health and Social Welfare, Prof. Muhammad Pate highlighted key achievements involving the NHIA at a Ministerial Sectoral Briefing. Pate emphasised the NHIA’s repositioning to expand insurance coverage for all Nigerians, particularly focusing on the less privileged. Presently, 1.8 million Nigerians are covered through the Vulnerable Groups Fund at the NHIA. He also mentioned forthcoming reforms aimed at strengthening the NHIA to broaden private health insurance for the informal sector and enhance health maintenance organisations (HMOs) in partnership with State Social Health Insurance Agencies (SSHIA). Additionally, Pate discussed the NHIA’s efforts in funding and equipping primary healthcare centers to ensure the provision of skilled birth attendance and essential services. Moreover, he underlined support for training programs for healthcare workers to equip them with the necessary skills and infrastructure to deliver quality care, especially in rural regions.

Racheal Abujah
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