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Universal Health Coverage For Nigerians



World Health Organisation (WHO)

One of the many areas that Nigeria has struggled to keep pace with leading countries in the world is in the area of universal health coverage.

Nigeria has failed to implement the Abuja Declaration, a commitment made 16 years ago along with other African countries as regards funding of healthcare when the country in 2001 hosted the heads of state of member countries of the African Union (AU).

The African leaders had pledged at least 15 percent of their annual budgets to enhancing the health sectors of their various countries. However, this is yet to become a reality in Nigeria as, to date, the country has not devoted more than six percent of its budget to the health sector.

It is reported that the highest budgetary allocation by the federal government since the declaration was 5.95 percent it spent on health in 2012.

In the 2019 budget proposal, President Muhammadu Buhari allocated N340.45 billion to the health sector, which is 3.9 percent of the N8.73 trillion expenditure plan.

This is a far cry from the 15 percent stipulated by the 2001 Abuja Declaration and less than the 4.16 percent and 4.23 percent allocated  to the health sector by the administration in 2017 and 2016 respectively.

A breakdown of the N340 billion health budget proposal for 2019 shows that the federal government intends to spend a paltry N1,888 on each citizen for the whole year.

Nigeria is lacking in health infrastructure and equipment, a situation that frustrates medical personnel in their bid to treat patients. This, coupled with poor remuneration, has paved the way for the mass exodus of medical personnel, causing brain drain in the sector.

These days, the doctor/patient ratio is a serious concern. In some public hospitals, one doctor attending to 100 patients per day is not uncommon.

Also disturbing is the various strikes by doctors and other health professionals, often spurred on by the neglect of their welfare and inadequate working environment, leading to patients being stranded as a result

A lot of poor Nigerians are turned away by health care providers if they are unable to pay, forcing them to patronise quacks or resort to self medication, both of which could worsen their ailments.

  This makes a compelling case for the country to adopt a universal health insurance system to cater for the poor and those who cannot afford medical expenses at the grassroots.

Also of concern is the increasing level of medical tourism in the country. Nigerians are said to spend N359.2 billion on medical tourism yearly.

The World Health Organisation (WHO) ranks Nigeria 187th out of 191 countries in terms of health care delivery. It is said that one-third of over 700 health facilities have been destroyed in the country and an estimated 3.7 million people are in need of health assistance.

WHO also noted that the life expectancy at birth in 2016 dropped to 55/56 years in the country.

It is our considered opinion that the federal government should pay more attention to creating awareness about the National Health Insurance Scheme (NHIS) to members of the Nigerian public and how they can benefit from being registered.

The NHIS is established under Act 35 of 1999 Constitution by the federal government to provide easy access to healthcare to all Nigerians and enhance healthcare delivery at an affordable cost through various prepayment systems.

The scheme offers social health insurance where the health bills of contributors are paid from the common pool of funds contributed by the participants of the Scheme. It is a pre-payment plan where participants make fixed regular payments. The fund is then pooled, allowing the Health Maintenance Organisations (HMOs) to pay for those needing medical attention.

Universal health insurance  is primarily a risk sharing arrangement which can enhance resource mobilisation and equity and is considered the most widely used form of health care financing globally.

Unfortunately for Nigeria, this helpful system is not in wide use, and the citizens, most of whom are poor, have to bear their health care burdens  all by themselves, leading to many avoidable deaths.

As a result, Nigeria has high disease incidence in many ailments, including having the highest maternal and infant mortality rates in the world.

We urge the federal government not only to keep to its commitment to the 2001 Abuja Declaration of 15 percent of its budget to the country’s health sector, but to see to its full implementation so that health infrastructure as well as the welfare of medical personnel and patients receive the needed attention.

Also, the government should expand the NHIS coverage to all Nigerians and create the necessary awareness in order to correct the general misconception that it is only for civil servants.



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