The Impact Of Health Insurance Scheme On The Aged Citizens Of Nigeria

Project and Seminar Material for Insurance

Abstract

This study was carried out to examine the impact of National health insurance scheme on aged citizens of Nigeria using Ilorin west local Government Area Ilorin, Kwara state as a case study. The survey design was adopted and the simple random sampling techniques were employed in this study. The population size comprise of residents in Ilorin west local Government Area Ilorin, Kwara state. In determining the sample size, the researcher conveniently selected 112 respondents and 100 were validated. Self-constructed and validated questionnaire was used for data collection. The collected and validated questionnaires were analyzed using frequency tables. The result of the findings reveals that the level of awareness of National health insurance scheme among aged Nigerians is low. The study also revealed that national health insurance scheme contributes to health-related welfare of aged Nigerians. It was further discovered that national health insurance scheme gives access to health services and financial protection to aged Nigerians. To mention but a few. Therefore, it is recommended that the scheme needs to be improved by expanding the scope of coverage to include hitherto excluded benefits. And guidelines for treatment should be re-structured such that health-givers can be flexible in administering treatment protocol. The idea of using mobile means to access insurance by having a prepaid mechanism, though beneficial, could be made more flexible. This can be achieved through a seamless contribution by way of percentage deductions from recharge card loaded. This might require legislative backing.

Chapter One

Introduction

1.1 Background of the Study

Health services are judged to be unsatisfactory and inadequate in meeting the needs and demands of the public as reflected by the poor state of health of the population (FMOH, 1998). It is realistic to argue that some of the deaths and serious illnesses which occur among Nigerians are due to conditions which are easily preventable with simple remedies. Lack of timely and appropriate care often increases the risk of serious complications in the course of minor ailments (Irinoye, 2004). The current high rate of morbidity and mortality can be substantially reduced by a more rational application of available resources, even at the time of financial stringency (Irinoye, 2004).

Various reform programmes have been put in place and government has expressed its determination to pursue a bold reform of the system. In the attempt by the government to ensure that all citizens attain a state of perfect physical, mental and social well being, it has formulated and implemented National Health Policy. The National Health Policy and Strategy to achieve health for all Nigerian’s came into effect in 1988 and was revised in 2004.
The main policy thrust of the National Health System includes Care Resources, National Health Interventions and Services Delivery, National Health Information Systems, Partnership for Health Development, National Research and Health Care Laws. In spite of a well structured health system, development of the Primary Health Care (PHC) has not improved the health experience of the population especially those in rural areas. The health sector’s contribution to national development remains a serious issue. Therefore, as part of government effort to address the problems in the sector, the National Health Insurance Scheme (NHIS) was initiated to address the health problems in Nigeria. The NHIS is a corporate body established under Act 35 of 1999 by the Federal Government of Nigeria to improve the health of all Nigerians at an affordable cost. Health Insurance is an approach that protects insured persons from paying high treatment costs during an episode ofsickness. The basic health insurance process is that a client makes a regular payment to a managing institution. This institution is responsible for holding the payments in a fund and paying a healthcare provider for the cost of the consumer’s care (Conn and Walford, 1998).

Data from the NHIS in 2011 shows 5% of the population are registered on the scheme (NHIS 2012b). Majority of those covered are in the employment of the federal and state governments and live in the urban areas (Lawan, Iliyasu, and Daso (2012). However, more than 60% of Nigerians belong to the informal sector and live in rural areas on less than $1 a day (as cited by UPI, 2012). Because they lack sufficient financial resources when faced with health challenges, they cannot afford good quality health care. Out-Of-Pocket (OOP) financing of health remains high at about 95.3% of the private expenditure on health (PvtHE) in 2010 (PvtHE as a percentage of Total Health Expenditure {THE} was 62.1% in 2010), and usually has a catastrophic effect on the poor. Many Nigerians have lost their lives due to their inability to meet this need (Lawan et al, 2012). NHIS is usually designed to significantly cater for the welfare of the citizens and especially the less privileged in the society (Kutzin, 2001). This, in essence, would guarantee access to care with financial risk protection. The scheme has been in operation since 2005 and the target date for achieving universal health coverage was 2015. From the above, this study seek to ascertain the impact of National health insurance on aged citizens of Nigeria.

1.2 Statement of the Problem

Nigeria’s health indicators have either stagnated or worsened during the past decade despite the federal government‟s efforts to improve healthcare delivery. Nigeria‟s life expectancy of 52.3years is below the African average of 56.05years, while child and maternal mortality rates are astounding. Annually, one million children die before the age of five due mostly to neonatal causes, malaria and pneumonia. Maternal mortality is 630 per 100,000 live births which is comparable to low-income countries such as Lesotho and Cameroon. An estimated 3.3 million Nigerians are infected with HIV and access to prevention, care and treatment is minimal. Nigeria also continues to combat the double burden of both communicable and noncommunicable diseases.

The National Health Insurance Scheme (NHIS) is an attempt by the Nigerian federal government to adopt universal health coverage (UHC) for her citizens. Dutta and Hongoro (2013) define UHC as ensured access to and use of high-quality health care services by all citizens and protection for all individuals from any catastrophic financial effect of ill-health. On their part, Gustafsson-Wright and Schellekens (2013) see UHC as referring to health systems providing both access to health services and financial protection which includes avoiding out-of-pocket payments that reduce the affordability of services and ideally some compensation for productivity loss due to illness. The aged citizens as used in this study refers to all persons of the population aged 50years and older in Nigeria. From the above, this study seek to ascertain the impact of National health insurance on aged citizens of Nigeria.

1.3 Objectives of the Study

The overall aim of this study is to critically examine the impact of National health insurance scheme on aged citizens of Nigeria. Hence, the study will be channeled to the following specific objectives;

Investigate the level of awareness of National health insurance scheme among aged Nigerians.
Determine whether national health insurance scheme contribute to health-related welfare of aged Nigerians.
Ascertain whether national health insurance scheme improve the quality of live of aged Nigerians.
Ascertain whether national health insurance scheme gives access to health services and financial protection to aged Nigerians.

1.4 Research Question

The study will be guided by the following questions;

What is the level of awareness of National health insurance scheme among aged Nigerians?
Does national health insurance scheme contribute to health-related welfare of aged Nigerians?
Does national health insurance scheme improve the quality of live of aged Nigerians?
Does national health insurance scheme give access to health services and financial protection to aged Nigerians?

1.5 Significance of the Study

The significance of this study is to highlight the ineffectiveness of aging programs and services in Nigeria, with a view to advocating changes in policy formulation and implementation of health programs and services so as to affect the elderly population. Currently, there are no overt programs and services for the elderly in Nigeria because there has not yet been a policy for the care of seniors in Nigeria. This paper will as well make advocacy for the establishment of such facilities in order to better the lot of the elderly population in Nigeria.

Additionally, subsequent researchers will use it as literature review. This means that, other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regards to the impact of National health insurance scheme on aged citizens of Nigeria.

1.6 Scope of the Study

This study is structured to generally examine the impact of National health insurance scheme on aged citizens of Nigeria. However, the study will further investigate the level of awareness of National health insurance scheme among aged Nigerians, determine whether national health insurance scheme contribute to health-related welfare of aged Nigerians, ascertain whether national health insurance scheme improve the quality of live of aged Nigerians, and ascertain whether national health insurance scheme gives access to health services and financial protection to aged Nigerians. The population of this study covers residents in Ilorin west local Government Area Ilorin, Kwara state.

1.7 Limitation of the Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

1.8 Definition of Terms

NHIS:

National Health Insurance Scheme.

UHC:

Universal Health Coverage.

PHC:

Primary Health Care.

Chapter Five

Summary, Conclusions and Recommendations:

5.1 Introduction

This chapter summarizes the findings onthe impact of National health insurance scheme on aged citizens of Nigeria using Ilorin west local Government Area Ilorin, Kwara state as a case study. The chapter consists of summary of the study, conclusions, and recommendations.

5.2 Summary of the Study

In this study, our focus was on the impact of National health insurance scheme on aged citizens of Nigeria using Ilorin west local Government Area Ilorin, Kwara state as a case study.The study is was specifically carried out to; Investigate the level of awareness of National health insurance scheme among aged Nigerians, determine whether national health insurance scheme contribute to health-related welfare of aged Nigerians, ascertain whether national health insurance scheme improve the quality of live of aged Nigerians, and ascertain whether national health insurance scheme gives access to health services and financial protection to aged Nigerians.

The study adopted the survey research design and randomly enrolled participants in the study. A total of 100 responses were validated from the enrolled participants where all respondent were residents in Ilorin west local Government Area Ilorin, Kwara state.

5.3 Conclusions

Based on the findings of this study, the researcher concluded that;

The level of awareness of National health insurance scheme among aged Nigerians is low.
National health insurance scheme contributes to health-related welfare of aged Nigerians.
National health insurance scheme improves the quality of life of aged Nigerians.
National health insurance scheme gives access to health services and financial protection to aged Nigerians.

5.4 Recommendation

Based on the findings of the study, the following recommendations are proffered.

The scheme needs to be improved by expanding the scope of coverage to include hitherto excluded benefits.
Furthermore, guidelines for treatment should be re-structured such that health-givers can be flexible in administering treatment protocol. The idea of using mobile means to access insurance by having a prepaid mechanism, though beneficial, could be made more flexible. This can be achieved through a seamless contribution by way of percentage deductions from recharge card loaded. This might require legislative backing.
An overhaul of NHIS policy should be made to incorporate care of the elderly in Nigeria.
Adequate funding of the program should be intensified for its smooth running and operations.
Bureaucratic bottlenecks should be removed and eliminated to allow for pragmatic service delivery to clients in need of healthcare.
Healthcare should not be seen as an economic commodity that is sold to the highest bidder, but should be seen as a fundamental right to be provided and protected by government.
Transparency and accountability should be implanted in the system to prevent and/or eliminate corrupt practices by administrators and providers of healthcare services.
Regular periodic monitoring, evaluation and re-planning of NHIS should be invoked.
There should be overt purposive commitment by governments at all levels who should as well provide oversight function in the running of NHIS in Nigeria.