The National Health Insurance Scheme (NHIS) has been in the news of late for negative reasons. So much so that one is forced to ask if the NHIS is jinxed. The history of the NHIS is replete with tales, tales by moonlight if you like. I am somewhat confused if you ask me because it appears something is fundamentally wrong somewhere.
I won’t bore you with how the NHIS came into existence by the Olusegun Obasanjo administration with Prof Eyitayo Lambo as minister of health. But I recall vividly when Prof Eyitayo Lambo declared on the launch of the NHIS on June 6th, 2005 that by 2025, Nigeria would have attained universal health coverage. But former president Olusegun Obasanjo who was in attendance interjected by saying instead of 2025, Nigeria would achieve universal health coverage by 2015.
Let us do some mathematics. 2017 minus 2005 equals 12. It means the NHIS has been in existence in the last 12 years with only about 4% health coverage. While countries like Ghana and Rwanda that at some point had to understudy our NHIS has achieved over 50% universal health coverage. Doesn’t this call for concern? In an interview granted by Prof Eyitayo Lambo, earlier this year, he said: “Before we handed over in 2007, we got some level of coverage of about 7 percent, but 12 years after, the country is below 5 percent coverage. Having birthed that baby, I feel despondent today”.
The question is at what point did we make the wrong turn? While I won’t spare the current administration, I would say that turn was taken by the Goodluck Jonathan administration and the Buhari administration revved dangerously on that road with the choice of the suspended Prof Usman Yusuf. That is another topic entirely. As a start, the issue of high turnover of chief executives is one major factor. Without mincing words, I would say the NHIS stopped breathing the moment Dr. Dogo Muhammad was shown the exit in 2012, not on the strength of non-performance but for reasons best known to Goodluck Jonathan and his cohort. The current minister of Education, Mallam Adamu Adamu, then a columnist with one of the leading newspapers wrote a brilliant article titled “For Want of a Godfather.” In the said article he lamented and equally lambasted former president Goodluck Jonathan for the way and manner Dr. Dogo Muhammad was shown the exit. Hear him:
“A highly qualified British-trained surgeon and a Fellow of the Royal College of Surgeons, Dr. Dogo-Muhammad had had an eventful tenure at the NHIS which as full of awards. The International Social Security Association gave Dogo-Muhammad’s NHIS/MDG Maternal and Child Health Project a Merit Award at an international get-together in Arusha Tanzania on December 6, 2011, and declared it as the best example of best practice worthy of emulation by other African countries. This award has been posted by President Jonathan on his Facebook as one of the achievements of his administration.”
“After launching Dr. Dogo-Muhammad’s Community-Based Social Health Insurance Programme in Isanlu, Kogi State, on December 17, 2011, President Jonathan was so impressed that he posted it on his ‘Neighbour 2 Neighbour’ social forum; and it is today recognised as one of the four notable achievements of the Federal Ministry of Health.
“At the end of Dr Dogo-Muhammad’s first tenure, the Minister of Health, Professor C. Onyebuchi Chukwu, assessed his stewardship as Executive Secretary of the NHIS, scored his performance as excellent and recommended the renewal of his second and final tenure of 5 years to President Goodluck Jonathan, in line with the provision of the NHIS Act. But here the president’s commitment to merit seemed to have suddenly vanished into thin air, and he directed that the vacancy is advertised. Yet, on the very day the president declined to approve Dr. Dogo-Muhammad’s reappointment, he approved the reappointment of the Chief Medical Director of Gwagwalada Specialist Hospital, and subsequently went on to approve the reappointments to the second tenure of the director general of the Administrative Staff College of Nigeria, ASCON, and the executive secretary of the Joint Admissions and Matriculation Board, JAMB, without asking that these vacancies be advertised.”
I guess you are perplexed. Amongst the numerous things Dr. Dogo Muhammad did at the NHIS, three things were outstanding. One was that during his tenure, NHIS was free from scandals unlike now, where all the past chief executives were somewhat given office spaces in the EFCC due to one scandal or the other. The second was that he grew the number of enrollees from 450,000 in 2006 to 5.6 million in 2012, unlike now that the figure has been depleted. The third was that he also increased the purse of NHIS from N12 billion to N94.8 billion. Those in the know of things then said “ Dogo won’t spend money if it is not for the growth of the scheme” and that was why he was able to build the NHIS to enviable heights.
And now, let me shock you all. Since Dr. Dogo Muhammad left, the NHIS has had five executive secretaries within the space of five years. And none of them could equal or build on his record at least. Yes, that is the truth. While I must state that this piece is not about Dr. Dogo Muhammad, instead it is an exposition of how not to govern a country.
In the case of Goodluck Jonathan, this was an agency that was recording progress on all fronts and assiduously working towards universal health coverage, but that didn’t mean anything to him. Instead, he brought in a politician to head the NHIS and in a year or so, the politician messed up the place that he was also asked to leave. And what was the implication? Successes recorded began crumbling. Another individual acted as chief executive for one year, and in truth, not much was expected from him because he was clueless about the dynamics of healthcare financing. The only visible thing about the tenure was that the chap was everywhere lobbying to be made substantive executive secretary. Mind you; the enrollee’s figure was dropping, as well as the purse of the NHIS, through lack of policy direction on the one hand and spurious contracts on the other hand.
Then, enter President Muhammadu Buhari. One had thought that he would have taken an interest in the NHIS since it was going to be an avenue for his administration to score some points, but instead, he brought in a supposed professor of oncology and paediatrics. This chap spent less than a year in the saddle, and the highlight of his tenure was that he was not afraid to spend money, since according to him; he has the mandate of the president. But I am not sure if part of the mandate were arrogance and financial recklessness. Just saying. I hear that his excesses at the NHIS were phenomenal and that was why he was suspended and investigated. I also learned that he is scheming to return despite the fact that he ran NHIS aground in less than one year. Wonders shall never end in this country.
– Jibrin worte in from Abuja
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