Evaluation Of The Problem Facing National Health Insurance Scheme In Nigeria

Evaluation Of The Problem Facing National Health Insurance Scheme In Nigeria

Chapter One

Preface

Background of the study

This study evaluates one of the cardinal objects of good governance which is to have effective healthcare delivery system put in place for the entire citizens. A healthy nation is a fat nation because of the absence of enervating conditions and pandemics in such a country, which, along with hunger and squalor, impoverishes the populace( Nwatu, 200012).

The public health insurance scheme( NHIS) functions as a social health insurance program designed by the civil government of Nigeria to ameliorate every services related to fiscal health sector, and to ameliorate access of health care for the maturity of Nigeria. The elaboration of the National Health Insurance scheme details back to 1962, when the need for health insurance in the provision of health care to Nigeria citizen was first blazoned. likewise, the preface of the structural adaptation program in 1986 negatively affected health allocation and other factors that led to the preface of the public health insurance scheme. This general poor stated of the nation’s health care services is giving the government a lot of concern. The conception of social health insurance was first mooted in 1962 by Heuvi commission, which passed the offer through the Lagos health bill. Unfortunately it was abbreviated in 1985,Dr. Emmanuel Usman, the minister of health set up a commission on public health review led byMr.L. Ligailu. At its 42nd meeting, the public council on health( NCH) approved the NIS to insure full private sector participation. This model assured the preface of health conservation association( HMO) and fiscal directors of the scheme. On October 15th the public health insurance scheme was eventually launched.

In the advanced world, insurance in one form or the other is a veritable and sustainable tool for backing healthcare. The National Health Insurance( NHIS) was launched in Nigerian on October 15, 1997 and was passed into law in May 1999. The original scheme has been modified to include healthcare for lower privileged persons in the country( FMH, 1998). According to the World Health Organization( WHO) in 2005, Nigeria was ranked 197th out of 2000 nations; life expectation was put at 48 times for manly and 50 times for womanish while healthy life expectation( HALE) for both relations was put at 42 times. Nigeria accounts for 10 of global motherly mortality with 59,000 women dying annually from gestation and child birth; only 39 are delivered by professed health professionals. In order to give indifferent distribution of health, the NHIS was introduced in Nigeria The need for the establishment of the scheme was informed by the general poor state of the nation’s healthcare services, inordinate dependence and pressure on the government’s provision of health installations, abating backing of health care in the face of rising cost, poor integration of private health installations in the nation’s healthcare delivery system and inviting dependence on out- of- fund charges to buy health. Like any other insurance scheme, the decoration for the NHIS is the quantum charged by the insurance compared with the pledge to pay for any eventual “ covered medical treatment ” for the designated “ content ”. Accordingly health insurance makes it possible to substitute a small but certain cost for a larger but uncertain loss( chain) under an arrangement in which the healthy maturity compensate for the pitfalls and costs of the unfortunate ill nonage. The NHIS presently represents 15 of one’s introductory payment. The employer is to pay 10 while the hand contributes 5 of his/ her introductory payment to enjoy healthcare benefits. The donation made by the insured person entitles his/ her partner and four children under the age of 18 to full health benefits( FMH 2005) NHIS was designed to give minimal profitable security for workers with regard to inimical losses performing from accidental injury, sickness, old age severance and unseasonable death of family pay envelope earner. NHIS is made mandatory because the government grounded on once gests prognosticated that some citizens can not engage in the scheme and the government also has the duty to cover the general weal of all citizens( Ibiwoye and Adedeke, 2007). It’s also the government’s belief that NHIS will help to break the vicious cycle of poverty in the country. It’s also a form of social support for workers( protruding, 2003). There’s lack of health care content and little equity. Access to healthcare is limited and most Nigerians are unfit to pay for health services and health installations are far from being equitably distributed. All these contributed to the limitation in health services( Samin and Awe, 2009). The available health services are veritably precious and the common man can not go it; only the privileged many can get access to good health. This study aims at assessing the position of knowledge and station of civil retainers occupant in Nigeria to NHIS.

According to Abacha( 19853), the public hospitals had come( consulting conventions” Given the rapid-fire population growth rate, what the nation demanded was a commensurable adding position of the services. But the dwindling finance of the government oil painting left the government with no other choice than reducing popular allocation to the health sector( Ozuh, 200430) previous to the government nearly solely financed health services in public health institutions. But by the turn of the 1980s, it had come common responsibility of the government and the citizens( Ughamadu, 200323). In other words both the government and the citizens participated the costs of healthcare services in public health institutions with the lesser burden importing heavily on the government. Subsidization of healthcare services was consummate in healthcare popular allocation.

Statement Of The Problem

In Nigeria, health insurance scheme is new; the target of its preface is to achieve good health to all citizens in Nigeria. utmost of Nigeria are jobless, resident in the pastoral areas without sanitarium, water and structure and shy labor force.

The experimenter intend to cross-question the strategies to be used in marketing health insurance in the situation of poor infrastructural development, severance and how position of income or capital and to compensate what will be the incapability factor in marketing health insurance scheme in Nigeria. To make suggestions to the government on the stylish way to vend health insurance programs with the pastoral support, private sectors andnon-governmental associations.

Ideal Of The Study

The main ideal of the study is to examine the evaluation of the problem facing public health insurance scheme in Nigeria.

Specifically, the study intend to;

i) To estimate the problems facing public health insurance scheme in Nigeria.

ii) Examine the benefits and problems of the scheme

iii) Examine the pretensions of the scheme

iv) Examine the places of the drivers of the scheme.

v) Identify colorful styles to be used in marketing health insurance service in Nigeria

Exploration Suppositions

For the successful completion of the study, the following exploration suppositions were formulated by the experimenter;

H0 there’s no significant problem facing public health insurance scheme in Nigeria

H1 there are significant problems facing public health insurance scheme in Nigeria

H02 there’s no significant relationship between the health insurance scheme and the Nigeria government.

H2 there’s a significant relationship between the health insurance scheme and the Nigeria government.

Signifcance Of The Study

It’s believed that at the completion of the study, the findings will be of benefit to the; Federal Ministry of Health, National Health Insurance Scheme Council( NHISC) to identify all the constraints to effective perpetration of the scheme. The nonsupervisory aspect of these challenges will be established in this study so that the NHISC will take remedial measures. To the Health conservation Organization( HMOs) as it’ll not only punctuate the challenges facing them under the scheme but will also give useful information on how they can effectively address these challenges especially those arising from their internal constituencies. To the Health Services Providers( HSPs), as those formerly operating under the scheme will be handed with useful information on how to brace up with their challenges while those not yet operating under the scheme will find in this study the need to be integrated into the public healthcare delivery system via the NHIS. To the government as the recommendations in this study will also be useful for its policy review in respect of the scheme.

Compass And Limitation Of The Study

The compass of the study covers the evaluation of the problem facing health insurance scheme in Nigeria. In the course of the study, the experimenter encounters some constrain which limited the compass of the study;

Time the time at the disposal of the experimenter which was allocated for the study was a major limitation as the experimenter had to combine other academic conditioning with the study.

Finance The finance at the disposal of the experimenter in the course of the study couldn’t permit wider content as coffers are veritably limited as the experimenter has other academic bills to cover.

Vacuity of exploration material The exploration accoutrements available to the experimenter at the time of this study were inadequate, thereby limiting the study.

Description Of Terms

EVALUATION the timber of a judgment about the quantum, number, or value of commodity; assessment.

HEALTH Health is the position of functional and metabolic effectiveness of a living organism. In humans it’s the capability of individualities or communities to acclimatize and tone- manage.

INSURANCE Insurance is a means of protection from fiscal loss. It’s a form of threat operation primarily used to hedge against the threat of a contingent, uncertain loss.

HEALTH INSURANCE Health insurance is a type of insurance content that covers the cost of an insured existent’s medical and surgical charges depending on the type of health.

The National Health Insurance Scheme( NHIS) is a body commercial established under Act 35 of 1999 Constitution by the Federal Government of Nigeria to ameliorate the health of all Nigerians at an affordable cost through colorful repayment systems.

Health Service Providers This refers to any health institution( sanitarium, health centers conventions, etc) authorized to give healthcare service under the NHIS( Ozuh, 200430).

Health conservation associations( HMOs) This refers to any authorized body or association to administer the NHIS by liaising between the NHISC and HSPs( Ozuh, 200430).

Healthcare Delivery System- This refers to the provision of health service to the people( Ughanmadu, 200323).

HMOs is an acronym for Health conservation associations( Uduma, 20053) 6. HSPs an acronym for Health Service Providers( Uduma, 20053)