Achieving Universal Health Coverage In Nigeria, How Feasible?

Earlier this year, the chairman of the Forum of Chief Executive Officers of State Social Health Insurance Agencies, Dr. Simeon Onyemaechi disclosed that only 8,107,795 Nigerians have been enrolled in the health insurance scheme across 34 states and the Federal Capital Territory (FCT) since 2018.

According to him, Universal Health Coverage (UHC), which means that all people have access to the full range of quality health services they need, when and where they need them, without financial hardship, cannot be achieved if any state is left behind in the scheme.

Presently, Oyo state, along with 33 states in Nigeria, plus the FCT, have rolled out health insurance scheme.

To boost uptake of health insurance among the vulnerables and reduce-out-of-pocket payment for health, the Oyo state government introduced the Oyo State Health Insurance Agency (OYSHIA) in 2016 and began enrolment in 2017. Its total enrollment to date is 190,968. While the formal sector has enrolled 104,533, the informal sector has 86,435 enrollees.

One of the beneficiaries of the scheme is Fatimah Lawal, a civil servant and Oyo state resident. “The price of drugs have skyrocketed in recent time, making it difficult for the common man to have access to quality healthcare services. Thus, you can only imagine how happy I was to discover about the Oyo State Health Insurance Scheme,” Lawal told LEADERSHIP, during a visit to the Oyo state government staff clinic in Agodi, Ibadan.

A general health practitioner at the Oyo state government staff clinic, Dr. Tunde Oyeyiola, told LEADERSHIP that the hospital is one of the healthcare providers under the health insurance scheme.

Oyeyiola said with as little as ₦600 per month, civil servants enrolled under the scheme can access healthcare services.

“I don’t even notice that N600 is being removed from my monthly salary. Yet, my family and i now have access to comprehensive healthcare services. We don’t pay a dime to access quality healthcare services at the Clinic. I must commend the Oyo state government for this initiative,” Mrs Lawal averred.

The executive secretary of OYSHIA, Dr Olusola Akande, at a two-day media dialogue tagged: “Changing The Narrative on Child Mortality Through Health Insurance,” in Ibadan, Oyo state, organised by OYSHIA in collaboration with the United Nations Children’s Fund (UNICEF), said, the aim of the scheme is to achieve Universal Health Coverage (UHC) in the state.

“While we have ensured all civil servants in the state are enrolled under the scheme, we are now extending insurance coverage benefits to vulnerable groups, so as to achieve UHC in the state,” Akande stated.

To this end, the Oyo state government has also extended the health insurance benefits to non-civil servants, the executive secretary of OYSHIA said, even as he disclosed that with just ₦13,500 per year, non-civil servants can access comprehensive healthcare services, with many residents already taking advantage of the opportunity.

For the vulnerable group in the state, Akande disclosed that the state government had committed N1billion for the enrollment of the vulnerables in the state. “With this fund, we are going to enroll all the street sweepers in Oyo state. The sweepers who constitute over 800 lives are majorly women. We will enroll them for free. We do this kind of enrollment on a regular basis as an innovative way to extend insurance coverage to vulnerable groups. We are also enrolling people living with HIV; that is the essence of insurance, providing insurance coverage for vulnerable groups,” he explained.

In her presentation titled “Access to Health Insurance: A Gateway to Achieve Universal Health Coverage for All in Nigeria’, Health Specialist with UNICEF, Dr. Ijeoma Agbo said despite the fact that the proportion of people with health insurance has been rising over time, there are still large gaps in coverage, leaving a sizable segment of the population—particularly the vulnerable—without insurance.

She said, UHC, is achieved when all people have access to high-quality essential services they need without facing financial hardship, particularly at the time of service delivery.

To accelerate progress towards UHC in Nigeria, Agbo said concerted efforts must be geared towards addressing systemic challenges as well as strengthening health systems. “Achieving UHC requires a multi-sectoral and collaborative approach involving government agencies, healthcare providers, donor agencies, civil society organisations, the private sector, communities, and the media,” she added.

She disclosed that UNICEF is committed to working together with all stakeholders to overcome barriers, leverage resources, and ensure that all Nigerians have access to the healthcare services they need without financial hardship.

Having health insurance is crucial for guaranteeing that kids get the proper medical attention they require to grow, prosper, and reach their full potential, the communication officer, UNICEF, Blessing Ejiofor, stated.

To close the current gaps in health insurance coverage for disadvantaged groups, she called on the media to take an active advocacy role by using their various platforms to bring attention to the issue.