National Health Insurance Scheme In Nigeria (NHIS); Prospects And Problems

Project and Seminar Material for Public Health

National Health Insurance Scheme In Nigeria (NHIS); Prospects And Problems


The intention of this research is to analyse the prospect and problems of National health Insurance scheme in Nigeria. Which will bring health care for all? In analyzing this topic I will give a brief introduction on how the scheme works and states the prospect and problem. Also a guideline will be drawn how the scheme will react in Nigeria now it has been established and lunched. How the problem will be solved.

The review of some other literature words on the subject matter “National health insurance scheme” the meaning and in detail the evaluation of health insurance in Nigeria.

I will also look into the problems associated with National health insurance the benefit or the scheme. Its role and methods of operation.

FINALLY: I will give a run down on how the researcher concluded his research work, the method and design used while work, the method and design used while undertaking the research. Also present and analysis the data obtain and draw a befitting judgment based on the responses received from the population sample, interviewed and how people react to the subject matter NATIONAL HEALTH INSURANCE SCHEME.”

Chapter One


This research work is a protection into the future of National health insurance scheme; financing through insurance in Nigeria. This work will serve as a survey on how Nigerians in general will react towards the operation of National health insurance scheme. Many researchers have made numerous proposals on how the scheme should be operated, but now the scheme has started. It will be proper to examine the market reactions, acceptability and its effect on the economy.

Moreover since the Logan “health care for all by the year 2000” is within its reality, it is felt that for such to be achieved, National health insurance scheme should take place. And the government, ministry of health and the general public should control the scheme. It has been noted that health insurance is more advanced and modern alternative to the tax-financed.

Nat with standing, this work gave a view of what National health insurance is, its forms, its benefits and other important aspects that will put a layman through on what National health insurance is. It was noticed that as government has taken up the scheme, it will encounter a lot of challenges and difficulties. This research work included recommendations on how the government could subdue such difficulties and challenges of health are delivery.

1.1 Background of Study

Since 1981 when the Nigerian medical Association held a conference in Calabar and Dr. E.M Umez Sroums delivered aa paper on “National health insurance” A practical approach to health care financing in a developing economy. He said that there has been growing need for National health insurance scheme in Nigeria. This issue has engaged the attention of medical doctors, insurance executive, the federal government of Nigeria, and Nigerian Newspapers which have carried a member of headlines on the topic.

But now the scheme has become a reality. The federal government lunched the scheme on 6th June 2005. Base on the establishment of the scheme, the purpose of providing health insurance which shall entitle insured persons and their dependents the benefit of prescribed good quality and cost effective health services as set out in this Decree. That is Decree of 2000. The body established for the management of the scheme are:

A governing council which shall subject to the decree, which has general control of the scheme. The council shall consist of the following members:

The chairman who shall be appointed by the head of state. Commander in chief of minister of health. Others are: each person to represent ministry of health, fiancé, government of the federation, Nigeria labour congress, N.E.C.A, private health care provided to carryout a research on this subject in order to highlight the problems militating against the scheme or problems which the scheme will face. Its prospects and make recommendations which will ensure the success of the scheme here in Nigeria.

1.2 Statement of the Problems

A lot have been done by various groups and bodies in order to come up with a benefiting scheme that will achieve an effective goal of health care for all Nigerians, which has been in highlights of government programmes.

There are problems that night hinder the effective national health insurance scheme in Nigeria.

  1. Inadequate public Enlightment on the need for national health insurance service.
  2. The population of Nigerians did not welcome the scheme
  3. Non introduction of phase by phase structurally scheme.
  4. Its marketing strategies and means of operating the scheme
  5. Non support of masses in response to the scheme for seminar.

In order to improve health care delivery system in Nigeria; the researcher must ensure that this research will problems that might hinder the effective National health insurance scheme in Nigeria.

1.3 Purpose of the Study

Based on the problems surrounding the scheme. This work will examine.

  1. To assess the knowledge of enrolees about the scheme.
  2. To identify constraints under the scheme experienced by enrolees
  3. To assess the level of enrolees satisfaction with NHIS.
  4. To examine lapses in the scheme

1.4 Significance of the Study

This projects will be of great importance to all Nigerians who for long shares same view that our Nation Nigeria need to adopt a health care insurance that will fair of loss cost, efficient and effective in the administration and operation.

However, on more pronounce detail, this study’s importance on individual basis that will be of help if its recommendation are adopted to facilitate the immediate acceptance of National health insurance by all, it will create health care finance awareness on a model way which will encourage personal contribution of ideas fiancé and materials towards ensuring a good health care delivery to all.

Organization, institutions and business entities who spent huge amount of money for there employees and families for health insurance will becomes operational in Nigeria. This will be achieved of such scheme is adopted in line with the research recommendation and the little amount saved will be channeled to other profitable venture.

Nigerians will also fire the study beneficial, if the guideline and recommendation are adopted in establishing National health insurance scheme in Nigeria which will obtain its health for all by the scheme.

The health sector will witness efficiency the scheme will eliminate corruption indiscipline, fraud and ensuring death reduction from, all health, this in variable will lead to an increase in Nigeria citizens due to in improving bur artic and depressed health care delivery system will on establishing National health insurance scheme will fined Nigeria a worthy place to live and their money.

1.5 Scope and Limitation of the Study

This work for easier understanding and implementation covers all analytical research aimed within the country for the establishment of health insurance including the held since 1990 till date for the establishment of National health insurance scheme. As National health insurance scheme has introduced now there are some problems that its prospects and problems that its prospects and problems in the economy.

During the project some problems faces the research they are:

  • Financial constraint
  • Time constraint
  • Knowing how the public will react as the scheme has been introduced today.
  • To identifying the suitable type of National health insurance in operating such scheme.
  • How to engage a massive support from all Nigerian if the response to the scheme is now.
  • Its marketing strategies and means of operating such scheme.

Those problems as mentioned will be relayed in details how each a constraint to this research work.

Financial constraint

Due to lack of enough fund, the researcher could not meet all required financial obligations which the work demands, this never, resulted to a few limitations.

Time constraint

As we know time is never on anyone’s side, so it was a constraint to our research work because there was other programmes such as examination quiz and other academic works which fell exactly within the period of our research work and all these programmes plus the research demanded till the same and equal attention.

1.6 Definition of Terms

i) Insurance Company:

A company registered or demand to be registered under the companies and Allied Matter Decree of 1997.

ii) Health:

It is a sound of bodily or mental condition of a person.

iii) Health Insurance:

The ability to get health services when required without having to pay fully at the time of need either because payment has previously been made by regular contributions by the insured or his/her employer or both.

iv) Health Care Delivery:

The act or process of administering effective medication and hospitalization to sick people in a community at a reduce rate.

v) Capitation:

Registered payment on personal basis to a doctor for giving health service to a person concerned when necessary.

vi) National Health Insurance Scheme:

It is a body corporate established under Act 35 of 1999 by the federal government of Nigeria to improve the health of all Nigeria at an affordable cost.

Chapter Five

Summary of Findings, Conclusion and Recommendations.

Social health insurance (SHI) has increasingly become the bed rock of providing healthcare for people in different countries of the world. The interest in this scheme is not limited to just putting the scheme in place but also in knowing how enrolees perceive the schemes where they exist. Over the years, there has been an upsurge in studying healthcare consumer’s awareness and perception of various forms of social healthcare insurance schemes. This study presents the empirical views of NHIS enrolees in Obafemi Awolowo University Ile-Ife, Osun state Nigeria. This section is organized into summary of findings, conclusion and recommendations.

5.1 Summary of Research Findings

The summary presented here is based on the analyses of findings shown in chapter four. The major findings of the study include the following:

  1. The respondents’ level of awareness of NHIS policy objectives was significant;
  2. Implementation of NHIS in the health centre has made access to healthcare delivery easy for enrolees in Obafemi Awolowo University Ile-Ife, Osun state;
  3. There is significant reduction in healthcare financing burden amongst NHIS enrolees in the institution;
  4. NHIS enrolees in the institution perceive the healthcare services to be efficient;
  5. NHIS enrolees in the institution prefer NHIS healthcare delivery than out of pocket expenses;
  6. Major challenge encountered by the enrolees is the inefficient referral system;
  7. Delay in release of NHIS cards to enrolee is a source of dissatisfaction.

5.2 Conclusion

Judging from findings from the research it is clear that there are challenges to the implementation of National Health Insurance Scheme at Obafemi Awolowo University Ile-Ife. These are delay in release of NHIS cards, inefficient referral system, long waiting time for patients, non-computerization of the services and enrolees trying to abuse the scheme.

5.4 Recommendations

In view of the findings of the research, it is hereby recommended as follows:

  1. All units of the Health Centre that are key to effective implementation of NHIS should commence 24-hour service delivery. More health personnel should be recruited for optimum health care delivery.
  2. It is recommended that a comprehensive digitalization of health insurance activity should be undertaken. This will facilitate the production and distribution of NHIS cards to enrolees, which has hindered care for many. The digitalization (biometric identity cards) should be deployed to cover the entire process, ranging from registration to encounter management at a point of service, including data administration. It is expected that digitalization will eliminate delays in processing eligibility for access and will reduce some forms of malpractices observable in the scheme. Presently, newly registered enrolees have to wait for about three months before they can access health care.
  3. A subscriber’s handbook/newsletter that will give details of the benefit package, medicines and subscribers’ rights and obligations should be compiled. The hand book should be made available to every enrollee at the point of registration.
  4. A quarterly policy dialogue forum should be arranged by the HMOs to acquaint enrolees with operational guidelines and the plans for future developments of the scheme.
  5. Necessary steps need to be taken to occupy the enrolees while they wait for consultation with the doctor. This can be achieved by providing them with newspapers or magazines to read.
  6. There should be a continual creation of awareness by the government to educate those who are currently not enrolled on the scheme.
  7. There is also the need to examine the long period it takes before the dispatch of registration cards to the enrolees so as to make it easy for those relocating from one place to another. Attempts should be made to minimize out of stock drugs. This does not match the objectives of the scheme. In essence, the Government should as a matter of necessity make all kinds of drugs prescribed by the doctors readily available to the enrolees, especially those covered by the NHIS drug list. This will not only reduce enrolees out of pocket expenses but the quality of the medicines will be assured. Majority of the respondents attest to NHIS improving their access to health care, the government should not stop at that but continue to provide more medical equipment to cater for various health needs of the enrolees as required.
  8. There is need for national surveys on enrolees self-evaluation of the scheme to enable the country formulate policies for addressing medical needs which will enhance enrolees’ health status.
  9. Computerization of the health centre should be done in order to provide easy access to patients’ health records, and information, for ease of retrieval, to update performance and care of the patient and maximal performance of the scheme. This computerization could be done and uploaded on the internet cloud for easy referral linkage.
  10. HMO should extend the working hours to weekends or create an emergency code that when a short message is sent to it, a referral code can be sent to the enrolees immediately.

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Frequently Asked Questions

What is the national health insurance scheme?

The Scheme established under the National Health Insurance Scheme Act, Cap N42, Laws of the Federation of Nigeria, 2004, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.

Does the Ghana national health insurance scheme improve access to health care?

The overall results suggested that the NHIS’s goal of improving access to health care has been achieved at least among adult women living in the Accra Metropolitan Area. References 1. Agyepong IA, Adjei S. Public social policy development and implementation: A case study of the Ghana national health insurance scheme.

Does NHIS reduce the financial burden of care in Ghana?

This study—the first to systematically review the achievements of NHIS in providing financial risk protection in the last 14 years—shows that despite some impact in reducing the financial burden of care, health care expenditure remains catastrophic for many insured individuals in Ghana. 

What is the NHIS online portal?

The NHIS online portal has been linked with Remita Platform to handle such payments and registration. The Scheme established under Act 35 of 1999 by the Federal Government of Nigeria, is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems.

Does national health insurance scheme improve health services utilization and outcomes?

Background: The introduction of the national health insurance scheme (NHIS) in Ghana in 2003 significantly contributed to improved health services utilization and health outcomes. 

What are the challenges of the Health Insurance Scheme implementation?

Most of the branch-level officials admitted that they do have a gap regarding the dissemination of program knowledge, and it is one of the major implementation challenges of the health insurance scheme.

What is the social health insurance scheme?

The social health insurance scheme is a mandatory insurance plan where the financing source is the employer or employee from salary or wage (Pan, Xu and Meng, 2016 ).

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