chapter One


1.1 Research background

The study assesses one of the main goals of good governance: establishing effective health care systems for all citizens. A healthy country is a prosperous country. Because in such countries there are no debilitating diseases or epidemics that impoverish their citizens with hunger and misery (Nwatu, 2000:

The National Health Insurance Scheme (NHIS) serves as a social health insurance program developed by the Federal Government of Nigeria to improve all services related to the financial health sector and increase access to healthcare for the majority of the Nigerian population. Let The development of the National Health Insurance system dates back to his 1962 when the need for health insurance to provide healthcare to Nigerians was first announced. In addition, the structural adjustment system introduced in 1986 had a negative impact on medical care, etc., and the national health insurance system was introduced. The overall poor state of health services in this country is of great concern to the government. The concept of social health insurance was first discussed in 1962 by his Heuvi Commission, which passed proposals through the Lagos Health Act. Unfortunately, it was shortened in 1985. Health Minister Emmanuel Usman has established a National Health Review Board chaired by L. Rigail. At its 42nd meeting, the National Health Council (NCH) endorsed NIS to ensure full private sector participation. This model ensured the inclusion of health maintenance organizations (HMOs) and system financial managers. Finally, on October 15, state health insurance was introduced.

In developed countries, some form of insurance is an effective and sustainable tool for financing healthcare. The National Health Insurance Fund (NHIS) was established in Nigeria on 15 October 1997 and came into effect in May 1999. The original system was modified to include health care for the country’s underprivileged (FMH, 1998). According to the World Health Organization (WHO) in 2005, Nigeria was ranked 197th out of 2000 nations; life expectancy was put at 48 years for male and 50 years for female while healthy life expectancy (HALE) for both sexes was put at 42 years. Nigeria accounts for 10% of global maternal mortality with 59,000 women dying annually from pregnancy and child birth; only 39% are delivered by skilled health professionals. In order to provide equitable 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, excessive dependence and pressure on the government’s provision of health facilities, dwindling funding of health care in the face of rising cost, poor integration of private health facilities in the nation’s healthcare delivery system and overwhelming dependence on out-of-pocket expenses to purchase health. Like any other insurance scheme, the premium for the NHIS is the amount charged by the insurance compared with the promise to pay for any eventual “covered medical treatment” for the designated “coverage”. Consequently 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 majority compensate for the risks and costs of the unfortunate ill minority. The NHIS currently accounts for 15% of basic salary. The employer pays 10% of the base salary, the employee pays his 5% and receives health insurance benefits. The insured’s premium ensures that the spouse and her four children under the age of 18 are in perfect health.

1.2 Problem Description

Nigeria has a new health insurance system. The goal of its introduction is to achieve good health for all citizens of Nigeria. Most people in Nigeria are unemployed and live in rural areas without hospitals, running water, infrastructure and understaffed.

The researchers plan to review and compensate health insurance marketing strategies in the context of poor infrastructure development, unemployment, income or capital levels, which are obstacles to marketing health insurance programs in Nigeria. Make recommendations to governments on how health insurance can be marketed by local sponsors, the private sector, and non-governmental organizations.

1.3 Purpose of the survey

The main objective of this study is to examine an assessment of the problems facing Nigeria’s national health insurance system. In particular, this study is intended to:

i) An assessment of the problems facing the Nigerian National Health Insurance system.

ii) consider the advantages and disadvantages of the system;

iii) consideration of program objectives;

iv) Consider the role of system operators.

v) Identify different methods used to market health insurance services in Nigeria

1.4 Research hypothesis

To successfully complete the study, the researchers made the following research hypothesis.

No major problems with Nigeria’s national health insurance system

Nigeria’s national health insurance system has serious problems

There is no material relationship between the health insurance scheme and the Nigerian government.

There is an important relationship between the health insurance system and the Nigerian government.

1.5 Importance of research

Once the study is complete, the results are expected to help the Federal Department of Health, the National Health Insurance Systems Council (NHISC), identify barriers to effective implementation of the system. The regulatory aspects of these challenges will be identified in this study so that NHISC can take corrective action. For Health Maintenance Organizations (HMOs), it not only highlights the challenges they face within their programs, but also provides useful information on how to effectively address those challenges, especially those arising from their internal constituents. . To Health Care Providers (HSPs). Those who are already in the program will receive useful information on how to adapt to the challenge, but those who are not yet in the program should use this study to integrate their findings into the program’s national health care. you’ll notice. System via NHIS. For the government, the recommendations of this research are also useful for reviewing the policy of the system.

1.6 Research scope and limitations

The scope of the study includes an assessment of the problems facing Nigeria’s health insurance system. During the course of research, researchers encounter several limitations that limit the scope of their research.

The amount of time available to researchers for their research was a major limitation, as they had to combine their research with other academic activities.

The financial resources available to researchers during the course of their research may not be able to cover a wider range as they have other academic bills to cover and resources are very limited.

Availability of research materials:
Insufficient research material available to researchers at the time of this study limited the study.

Definition of terms

To make judgments about the quantity, number, or value of something. evaluation.

Health is the level of functional and metabolic efficiency of an organism. In humans, it is the ability of individuals or communities to adapt and self-govern.

Insurance is protection against financial loss. It is a form of risk management used primarily to hedge the risk of potential and uncertain losses. Health insurance:
Health insurance is a type of insurance that compensates the insured for medical and surgical expenses according to their health condition.

National Health Insurance System (NHIS):
An entity established by the Federal Government of Nigeria under Law 35 of his 1999 Constitution to improve the health of all Nigerians at an affordable cost through various advance payment schemes.

Healthcare Professionals; Medical Institutions:
– This refers to all medical institutions (hospitals, health centers, clinics, etc.) authorized to provide medical services under the NHIS (Ozuh, 2004:

Health Maintenance Organization (HMO):
– This refers to the accredited agency or organization that administers the NHIS by acting as an intermediary between NHISCs and HSPs (Ozuh, 2004:

Medical system:
– This refers to the provision of medical services to people (Ughanmadu, 2003:
twenty three). HMOs is an acronym for Health Maintenance Organizations (Uduma, 2005:
3) 6. HSPs is an acronym for Health Service Providers (Uduma, 2005:


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