EVALUATION OF THE PROBLEM FACING NATIONAL HEALTH INSURANCE SCHEME IN NIGERIA. A RESEARCH PROJECT TOPICS ON INSURANCE
1.1 Background of the study
This study evaluates one of the cardinal objectives of good governance which is to have effective healthcare delivery system put in place for the entire citizens. A healthy nation is a wealthy nation because of the absence of debilitating diseases and epidemics in such a country, which, along with hunger and squalor, impoverishes the citizenry (Nwatu, 2000:12).
The national health insurance scheme (NHIS) functions as a social health insurance program designed by the federal government of Nigeria to improve every services related to financial health sector, and to improve access of health care for the majority of Nigeria. The evolution 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 announced. Furthermore, the introduction of the structural adjustment program in 1986 adversely affected health allocation and other factors that led to the introduction of the national health insurance scheme. This general poor stated of the nation’s health care services is giving the government a lot of concern. The concept of social health insurance was first mooted in 1962 by Heuvi committee, which passed the proposal through the Lagos health bill. Unfortunately it was truncated in 1985, Dr. Emmanuel Usman, the minister of health set up a committee on national health review led by Mr. L. Ligailu. At its 42nd meeting, the national council on health (NCH) approved the NIS to ensure full private sector participation. This model ensured the introduction of health maintenance organization (HMO) and financial managers of the scheme. On October 15th the national health insurance scheme was finally launched.
In the developed world, insurance in one form or the other is a veritable and sustainable tool for financing 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 less 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 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.