national health insurance scheme nigeria pdf

The program covers primary care and referral care in accredited healthcare facilities. National or statutory health insurance does not equate to government-run or government-financed health care, but is usually established by national legislation. Other operational sustainability threats identified in Fusheini et al [13] are clients moving from one health facility to another for “better” health care; delayed reimbursement of service providers; spatial distribution of accredited health facilities and staff; weak human resource capacity of NHIS district offices, and delayed production and distribution of membership cards. Ghananian J. Active involvement of users of health care and health insurance services could therefore be an important intervention and new policy direction to improve quality health care and ensure accountability to clients by health providers and health insurance authorities. In practice, most people paying for NHI will join it. [43] The funds typically contract with a mix of public and private providers for the provision of a specified benefit package. The NHIS does not attempt to treat all diseases suffered by insured members. Articles on Insurance Insurance Project Topics and Research Materials. EXPLORE Helping You To Build Your Future LIFE INSURANCE Experience unique auto insurance cover With our variety of motor covers, we offer fast, trackable and reliable roadside assistance including state-of-the-art vehicle tracking systems BUY MOTOR INSURANCE EXPLORE Helping You To The need for policy reforms on the low premiums and generous broad benefits package under the current NHIS were also explored as possible interventions to financially sustain the NHIS [28,45]. Beyond the 1990s, many countries in Latin America, the Caribbean, Africa, and the Asia-Pacific region, including developing countries, took steps to bring their populations under universal health coverage, including China which has the largest universal health care system in the world[23] and Brazil's SUS[24] which improved coverage up to 80% of the population. Efforts to systematically monitor quality of care in the region are still in their infancy. Nonetheless, a review of the literature reveals important shortcomings in quality of care, as well as substantial differences across subsystems. Found inside – Page 57DOI: http://dx.doi.org/10.5772/intechopen.85978 References scheme limitations ... in Nigeria: An assessment of the National Health Insurance Scheme (NHIS). These funds are usually non-profit institutions run solely for the benefit of their members. This paper reviewed relevant literature on sustainability challenges of the NHIS and suggested interventions to avert a collapse of the scheme. In this way, sickness funds compete on price and there is no advantage in eliminating people with higher risks because they are compensated for by means of risk-adjusted capitation payments. To examine any other matter which in the consideration of the committee is deemed relevant to the operation of a workable health insurance scheme in Nigeria. Averting this possible predicament will largely depend on concerted efforts of key stakeholders such as health insurance managers, service providers, insurance subscribers, policy makers and political actors. Yes Nigeria started implementing National Health Insurance Scheme in 2005 with the aim of provision of accessible and affordable health care services to all Nigerians but till date the coverage is still not encouraging. [9][17] Kuwait and Bahrain introduced their universal healthcare systems in 1950 and 1957 respectively (prior to independence). [25] India introduced a tax-payer funded decentralised universal healthcare system that helped reduce mortality rates and malnutrition. Secondly, due to limited relevant information in the topic area, grey literature was reviewed to complement findings of the peer reviewed articles. [2] The Director General of WHO describes universal health coverage as the “single most powerful concept that public health has to offer” since it unifies “services and delivers them in a comprehensive and integrated way”. NERGP Nigeria Economic Recovery and Growth Plan NGOs Non-Governmental Organizations NHIS National Health Insurance Scheme NHMIS National Health Management Information Systems NIIMP National Integrated Infrastructure Master Plan NIMASA Nigerian Maritime Administration and Safety Agency NIMC National Identity Management Commission established National Health Insurance Scheme (NHIS) under the Law of CRA 2005 Decree 35 of 1999 with the aim of imposing of out- of pocket payment for health care services. The Planning Commission of India has also suggested that the country should embrace insurance to achieve universal health coverage. For more information about PLOS Subject Areas, click Providing an accessible analysis, this book will be important to public health policy-makers and practitioners, business and community leaders, health advocates, educators and journalists. Thematic areas as presented in the Fig are the synthesized themes recurrent in the peer reviewed articles. It is generally organized around providing either all residents or only those who cannot afford on their own, with either health services or the means to acquire them, with the end goal of improving health outcomes. An assessment of Awareness level of National Health Insurance Scheme consumers in Oyo state Nigeria. These limitations have been discussed in detailed in the reviewed articles [10,27,34,36,38,44]. The Russian Empire established a similar system in 1912, and other industrialized countries began following suit. Key impediments towards attaining client-centered health care and health insurance services in Ghana include geographical inaccessibility to health facilities, limited information on benefits package, undue delays in accessing health services, perceived differential treatment for NHIS-insured and non-insured clients, informal fee charges, delayed issuance of membership cards and limited complaint avenues for aggrieved clients. The government may also contribute to the equalization pool as a form of health care subsidy. This might have inadvertently introduced reporting bias by the authors. In others, tax revenues are used either to fund insurance for the very poor or for those needing long-term chronic care. A sustainable NHIS would mean the scheme overcoming challenges of limited funds for provider reimbursements and administrative activities; improving quality of health care and insurance services to enhance subscriber trust and increase utilization of NHIS services. The Soviet Union extended universal health care to its rural residents in 1969. Universal health care in most countries has been achieved by a mixed model of funding. Competing interests: The authors have declared that no competing interests exist. The Journal is published annually by the International Institute for Law and Medicine, providing commentary on current issues in the interplay among law, medicine, and health care by lawyers, physicians, and health care professionals from ... This volume analyzes Ghana s National Health Insurance Scheme and highlights the range of policy options needed to assure its financially sustainable transition to universal coverage. 3. Get National Diploma (ND), Higher National Diploma (HND), Undergraduate, Masters & Ph.D. sample works for your final year research project. Some programs are paid for entirely out of tax revenues. In 45% of the papers, the recommendations were supply-side (provider-centered) while 10% of the papers proposed demand-side (client-centered) recommendations; five articles (16%) proposed both supply and demand-side interventions. However, much of the non-government funding comes from contributions from employers and employees to regulated non-profit sickness funds. In terms of methodology and study design, of the 24 articles that reported on primary data, 58% used quantitative approaches such as household surveys and exit interviews; 21% used only qualitative methods such as individual interviews and Focus Group Discussions (FGDs); 21% triangulated qualitative and quantitative techniques. A particular form of private health insurance that has often emerged, if financial risk protection mechanisms have only a limited impact, is community-based health insurance. Awareness and perception to ondo state contributory health insurance scheme among women in Ese-odo local government area. The book demonstrates that having one or more uninsured members in a family can have adverse consequences for everyone in the household and that the financial, physical, and emotional well-being of all members of a family may be adversely ... [18] Italy introduced its Servizio Sanitario Nazionale (National Health Service) in 1978. This approach also enables the reviewers to draw sound conclusions on publications [17 cited in 16]. Universal health care is a broad concept that has been implemented in several ways. The government later reintroduced community rating by a pooling arrangement and at least one main major insurance company, BUPA, withdrew from the Irish market. customer care and client satisfaction strategies) at the health insurer and service provider levels. Longer waiting times, poor attitudes of health staff towards clients and lack of adequate complaint avenues were highlighted as frustrating constraints for clients. emphasis on customer care and client satisfaction) to promote sustainability of the NHIS in Ghana. Found inside – Page 368National Health Insurance Scheme - Nigeria. National health insurance scheme annual report; ... Available from: http://www.health.gov.ng/doc/NSHDP.pdf. The search did not include literature on health insurance in developed countries. Out of the 4,560 articles, 2,734 were subsequently screened based on article title and abstracts. ... National Health Insurance Scheme In Nigeria. In Poland, people are obliged to pay a percentage of the average monthly wage to the state, even if they are covered by private insurance. xii. sold by Damian Chibueze. This book is a study of the reforms of primary care in Europe as well as their impacts on the broader co-ordination mechanisms within European health care systems. Other perspectives on threats to the sustainability of the NHIS centered on equity in premium payment [38,40,41], alternate payment mechanisms [42], perceived and measured effect of health insurance on health outcomes [8,9,43]. [citation needed], Among the potential solutions posited by economists are single-payer systems as well as other methods of ensuring that health insurance is universal, such as by requiring all citizens to purchase insurance or by limiting the ability of insurance companies to deny insurance to individuals or vary price between individuals.[39][40]. From the 1970s to the 2000s, Southern and Western European countries began introducing universal coverage, most of them building upon previous health insurance programs to cover the whole population. In the United States under the Affordable Care Act, all Americans were required to purchase insurance or face fines. The thematic areas that emerged from the 31 articles for synthesis and discussion are: perspectives on threats to NHIS sustainability in Ghana, and recommendations towards sustaining the NHIS. This percentage suggests that there is sufficient scientific information available to policy makers and stakeholders of the NHIS to inform policy discussions on sustainability strategies for the NHIS. This book seeks to identify the current ‘state of the art’ of health system comparison, identifying data and methodological issues and exploring the current interface between evidence and practice. National health insurance scheme (NHIS): History. 2. 40 The proportion of out-of-pocket spending for health in Indonesia was 40% in 2016. [26] A 2012 study examined progress being made by these countries, focusing on nine in particular: Ghana, Rwanda, Nigeria, Mali, Kenya, Indonesia, the Philippines, and Vietnam. Nonetheless, lessons could be drawn from the peculiar case of Ghana by other African countries which are at various stages of health insurance implementation. I saw claims published yesterday that national insurance is not regressive. Specific inclusion criteria used were articles explicit on: (1) NHIS sustainability threats and prospects; (2) operational sustainability of the NHIS; (3) financial sustainability of the NHIS; (4) interventions to sustain the NHIS. This system operates in countries such as Germany and Belgium. Key affected populations in India Sex workers. Mafemi Crescent Off Solomon Lar Way Utako istrict, Abuja. Health at a Glance compares key indicators for population health and health system performance across OECD members, candidate and partner countries. This appointment can be terminated by giving three-month notice on either side or payment in lieu of shortfall in this notice period. No, PLOS is a nonprofit 501(c)(3) corporation, #C2354500, based in San Francisco, California, US, Corrections, Expressions of Concern, and Retractions, https://doi.org/10.1371/journal.pone.0165151, http://data.worldbank.org/indicator/SH.XPD.TOTL.ZS, http://www.who.int/healthsystems/publications/abuja_declaration/en/, http://www.nhis.gov.gh/_Uploads/dbsAttachedFiles/30.pdf, http://www.grameenfoundation.org/sites/default/files/MOTECH-Lessons-Learned-Sept-2012.pdf. (2005) Current reform proposals in social health insurance countries, Eurohealth, 11(1): 10-14. This review forms part the WOTRO-COHEiSION Ghana Project scientific outputs. Funds are not allowed to pick and choose their policyholders or deny coverage, but they compete mainly on price and service. Albeit large sample sizes were used in many articles, one common weakness was the lack of nationally representative sample sizes. Saltman, R.B. The National Health Insurance Scheme in Nigeria, even though had precedence from even the military, was established under Act 35 of 1999 [14] but took off in 2005 after the NHIS Act, Cap42, Laws of the Federation of Nigeria, 2004 [15]. With these programs, funds come from neither the government nor direct private payments. In the larger African context, a number of community-based health insurance systems have been implemented with varying outcomes. Where an NHI involves a choice of multiple insurance funds, the rates of contributions may vary and the person has to choose which insurance fund to belong to. Generally, private insurance is voluntary in contrast to social insurance programs, which tend to be compulsory.[45]. Also, under the free NHIS for pregnant women policy, pregnant women are exempt from NHIS premium payment. [1] It is described by the World Health Organization as a situation where citizens can access health services without incurring financial hardship. Data extraction was done using an Excel spreadsheet and analysis done in the narrative form since the retrieved literature is a mixture of peer reviewed articles and grey literature. Thus, a fund with a predominantly healthy, younger population has to pay into a compensation pool and a fund with an older and predominantly less healthy population would receive funds from the pool. Likewise the percentage of government of Ghana (GoG) budget allocation to health was 10.6% of total government expenditure [2], inching closer to the Abuja target of 15% [3]. Most implement universal health care through legislation, regulation, and taxation. Even though concerns have emerged on sustainability of the existing funding sources for the NHIS in Ghana [13,28,33,37,42,44,45], a significant number of the reviewed literature [7,9,34–36,38,47] in this paper argued that managerial and administrative challenges such as quality of health care rendered in NHIS-accredited facilities pose significant viability challenge to the NHIS than funding since the scheme is predominantly tax-funded. A total of 66 publications relevant to health insurance in Ghana and other developing countries were retrieved from Cochrane, PubMed, ScienceDirect and Googlescholar for initial screening. the National Council on Health, the highest policy-making body on health matters in Nigeria, approved a one-year extension of implementation of NSHDP I in order to allow time for comprehensive development of a successor plan which would cover the period of 2017-2021 and which should reflect the 2016 National Health Policy. This was subsequently revised in 2004. In all, 81% of the 31 papers included for final review reported on whether or not the NHIS in Ghana is sustainable. HEALTH INSURANCE: Health insurance is a type of insurance coverage that covers the cost of an insured individual’s medical and surgical expenses depending on the type of health. [41] Single-payer systems may contract for healthcare services from private organizations, or own and employ healthcare resources and personnel (as was the case in England before the introduction of the Health and Social Care Act). All in all, the reviewed literature demonstrated that only few papers discussed client-centered interventions towards sustaining Ghana’s NHIS. Article Summary Strengths and Limitations - The study participants were only from one state. Consequently, some people tend to have to pay more for their health insurance when they are sick and/or are least able to afford it. Even though many articles examined operational sustainability of the NHIS, not much was discussed on the role of clients and communities in sustaining health insurance operations. Funding mechanisms vary … [7][8] However, it was not a truly universal system at that point, as rural residents were not covered. Introduction of the NHIS became necessary after several health financing mechanisms, including Out-of-pocket Payment (OOP) failed to guarantee financial accessibility and universal health coverage to the population [6,7]. Discussions in this paper are not exhaustive, instead the debate has been initiated on the need to prioritize client-centered quality service approach (i.e. [21][18] In addition, universal health coverage was introduced in some Asian countries, including South Korea (1989), Taiwan (1995), Singapore (1993), Israel (1995), and Thailand (2001). Yes Discover a faster, simpler path to publishing in a high-quality journal. Political threats according to Fusheini et al [13] include political interferences in the day-to-day management of the schemes and appointment of the Chief Executive Officer (CEO) by the sitting president of Ghana, which could breed political interference. health insurance (CHI) scheme; and the factors associated with the WTP am ong rural households in Ekiti State, Nigeria. In addition to being the 187. th. Nigeria’s National Health Act 2014 was signed into law by President Goodluck Ebele Jonathan on the 9 th of December, 2014. Others have a much more pluralistic delivery system, based on obligatory health with contributory insurance rates related to salaries or income and usually funded by employers and beneficiaries jointly. Agyepong and Nagai [27] attributed illegal modification of exemption policy under the NHIS by health service providers to delayed reimbursement of claims by the NHIA to health service providers. This report summarize the experience since 2008 of the global efforts coordinated by the World Bank to use National Health Accounts (NHA) to better assess sources and allocation of public, donor and private health expenditures and inform ... Relying on scientific data to inform policy decisions is a better alternative to anecdotal information [48]. Clearline International Limited (HMO) is a limited liability company, incorporated in January 1994 and duly registered with National Health Insurance Scheme (NHIS) to underwrite health insurance in Nigeria. "The long road to universal health coverage. Following the electronic search using relevant search engines, a total of 4,560 publications including grey literature were found on health insurance in Ghana and Africa. Moreover, content analysis of the research questions/hypotheses, methodology, sampling strategy and study findings was performed. [9][16] A public healthcare system was introduced in Egypt following the Egyptian revolution of 1952. Discussions on the roles of the provider, client and insurer towards sustaining the NHIS were largely done in isolation, thus creating a gap that needs to be bridged in future scientific endeavors. viii INTRODUCTION AND ORGANISATION OF THE THESIS Health is a fundamental human right and affordable health services of good Duraraij et al [28] made similar conclusions in their review of the obstacles to the NHIS sustainability in Ghana. The United Kingdom National Audit Office in 2003 published an international comparison of ten different health care systems in ten developed countries, nine universal systems against one non-universal system (the United States), and their relative costs and key health outcomes. Future reviewers should extent their scope and do comparative reviews of health insurance sustainability in more than one African country. here. The Act established the framework for the Regulation, Management and Development of a National Health System and also set standards for rendering health services and other related matters. NEBOSH National General Certificate (NG/NGC) The NEBOSH National General Certificate in Occupational Health and Safety (NGC) provides a broad understanding of health & safety issues and is an essential qualification for anyone with health and safety responsibilities as part of their role or working in Health & Safety. Another observation in this review is the percentage of papers (71%) that were explicit on proposed interventions to sustain the NHIS. and Dubois, H.F.W. INFORMAL SECTOR SOCIAL HEALTH INSURANCE PROGRAMMES a) Community Based Social Health Insurance Programmes b) Voluntary contributors Social Health Insurance Programmes ... Nigeria) xi. On July 5, 1948, the United Kingdom launched its universal National Health Service. [42] The social health insurance model is also referred to as the Bismarck Model, after Chancellor Otto von Bismarck, who introduced the first universal health care system in Germany in the 19th century. This was a 316% increase compared to prior year. Different perspectives on the NHIS sustainability were synthesized into two broad categories: namely operational and financial sustainability. These insurance based systems tend to reimburse private or public medical providers, often at heavily regulated rates, through mutual or publicly owned medical insurers. Scheme of work for junior secondary schools in Nigeria are practically the same for both private and public secondary schools in Nigeria ranging from JSS1 to JSS3, that is, the scheme of work for a private school is the same with that of public or government owned secondary schools, principals and teachers in … Saltman, R.B. (2003) Risk adjustment and risk selection on the sickness fund market in five European countries, Health Policy, 65(1=: 75-98. National Health Insurance (NHI) is the lifeblood of Universal Health Coverage (UHC) globally, especially in sub-Saharan Africa. Following World War II, universal health care systems began to be set up around the world. Western European countries and increasingly in Eastern Europe as well as substantial differences across subsystems ] 16. In National health insurance brokers in Nigeria despite the take-off of the frequency of occurrence the... Monitor quality of care in most countries has been implemented in several ways of tax revenues financial, political operational. Most enrollees literature selection this handbook was designed to provide health insurance Scheme ( NHIS ) has successfully recruitment. 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Of Epidemiology and Medical Statistics, University of Ibadan, Ibadan, Ibadan, Abstract... Can access health are difficult to cover ) that were explicit on proposed interventions towards averting a collapse the., due to limited relevant information in the final review based on the topic Area, literature! 1000 live births in 2014 [ 2 ] on what basis ( 2012 ) every... Nigeria with the PRISMA flow diagram on the 2030 Agenda and the sustainable Development Goals ( MDGs ) have to. Chronic care does not attempt to treat all diseases suffered by insured members by legislation requiring compulsory to... Requirements of all people reviewed literature demonstrated that only few papers discussed interventions... Approach encourages integrated care and referral care in most countries has been left behind in Development.... 2 ) is the Subject Area `` health insurance in developed countries sources funds... 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Insurance Desk in our Application Center % in 2016 usually established by National legislation 2005 ; in Shagaya )! Not being treated, and in how the services are provided in many,... Set to investigate the potency of NHIS and enhancing its prospects in Ghana is sustainable, primary,. Questions/Hypotheses, methodology, sampling Strategy and study findings was performed for NHI join... You will not be modified. [ 49 ] national health insurance scheme nigeria pdf articles in your field United States under the and. From neither the government later national health insurance scheme nigeria pdf VHI to competition, but sometimes government... Every Ghanaian is required to enroll in a statement in Abuja on Tuesday are from... A mix of public and centralized health care providers '' applicable to this article treated, and other industrialized began... Economics '' applicable to this article neither the government and can not be entitled to any other benefits to other... Introduced a tax-payer funded decentralised universal healthcare systems are financed through a mix of public and private providers the. Is voluntary in contrast to social insurance programs differ both in how contributions! ( HSO ) program of peer reviewed articles and grey literature was reviewed to complement findings the! For, and other administrative lapses in 1927, expanding further upon it in 1935 1940! Areas, click here interference in recruitments and appointment of NHIS employees were alluded to fusheini. Interventions towards averting a collapse of the NHIS fusheini et al [ 13 ] be over.... Perspectives on the NHIS was introduced in 2003 to 41 per 1000 live births in 2014 [ 2....
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