Over time, healthcare financing in Nigeria has are derived from public funding, health insurance scheme, external loans, grants and out-of-pocket settlement for medicare. With this initiative unable to guarantee universal health coverage for all those, seeking innovative means towards financing the sector is vital as 2015 date for universal coverage of health hots up, writes ALEXANDER CHIEJINA.
If your global financial crisis began within 2007, countries across the globe were not immuned as they faced complications managing resources at their convenience to effectively address the contentment of its citizens.
While the problem became dire in the face of increasing healthcare costs, economic burden of emerging and re-emerging diseases for example HIV and TB, poor health care system performance, etc, within your framework of scarce resource amid increasing competing demands, Nigeria’s monetary allocation to health sector due to the fact 1999 has remained between 3. 1 per cent to 7. 5 percent; which is far from optimum despite agreement because of the Abuja Declaration by African Heads of States in 2000 to devote at the least 15 percent of budget part to health.
For the government to meet up with the Abuja Commitment, the 2013 budget would've required a proposal of N738 thousand, thereby having a shortfall regarding N459 billion in 2013, BusinessDay’s Investigation and Intelligence Unit shows.The research shows that in line with the 2013 budget proposal, the nation’s health budget involves about N1, 680 per person per year. This is well below an average recommended minimum spend of concerning N6, 820 per head because of the World Health Organisation (WHO).
To meet WHO’s target, Nigeria’s annual health expenditure in 2013 ought to be N1. 13 trillion, which is concerning 23 percent of Nigeria’s 2013 spending budget proposal. This creates a healthcare funding gap of N852 billion inside the 2013 budget. It is however clear that the federal government cannot bridge the healthcare funding gap without significantly diverting resources from other sectors in the economy.
Till now, the health sector may be financed by public funding, by means of regular budgetary allocation by federal government, state and local governments, and additional budgetary allocation like the help with your debt savings, SURE-P, etc, as nicely as private funding through households’ out-of-pocket health payments (user fees, co-payments, etc) and employers’ health coverage for their employees.
Since external loans and grants coming from multilateral institutions like World Financial institution, African Development Bank (AfDB), bilateral resources, international foundations, Global Fund, AMFm, UNITAID as well as health insurance schemes are currently being harnessed for healthcare financing, the lack of financial protection has placed more than 90 percent of Nigerians to rely on out-of-pocket payment for medicare.
Giving an insight into your nation’s healthcare financing, Eyitayo Lambo, ex - minister of health, explained which high out-of-pocket payment with clerk risk of catastrophic health spending, low coverage with risk-pooling components, low priority accorded to health by state and city health spending relative to that of Govt, ineffective health services largely caused by inadequacy of and inequity within health financing, inadequate availability and reach, unequal access and low quality of health services all bring about poor health status of individuals.
While insurance penetration, which is a measure of the relationship between premiums earned along with the nation’s Gross Domestic Product, will be put at 0. 6 percent because of the Nigerian Insurers Association, the National Medical care insurance Scheme, NHIS, established in 2005 through an overarching goal of universal coverage of health by the year 2015, seems to be bleak. Stakeholders believe the scheme presently covers under 5 million Nigerians - both inside the public and private sectors.
In pursuance of universal coverage of health for all, stakeholders in this sector have called for your strengthening of capacities of public health infrastructure to produce effective, safe and quality health services, raising sufficient resources regarding health - from domestic and external sources, promoting efficiency of national health services to optimise resources and maximise results and remove financial risks and barriers to gain access to through compulsory prepayment - payment before desire for healthcare arises.
While patients have increasingly shared inside the financing of government health services through the payment of consultation charges along with the purchase of drugs and other renewable items for the reason that health institutions have inadequate federal provision, several African governments planned the introduction or expansion regarding insurance-based healthcare financing, to raise additional revenue to fund the price tag on healthcare provision as well because diminish financial barriers to obtaining health care in the time illness.
As calls for government to relieve the burden of healthcare services on the citizens continues, the quest to attain universal coverage of health for Nigerians may not become realised if there is nothing done to amend the recent NHIS Act established under React 35 of 1999 by the federal government to make health insurance necessary and subsidized.
They however think that a constitutional amendment would compel states and local governments to spend subsidy and bridge existing funding gaps that may ensure and enable more Nigerians access quality healthcare underneath the NHIS.
Speaking with BusinessDay, Abdulrahman Sambo, exec secretary, NHIS, explained that the NHIS scheme was made to facilitate fair financing of health costs through pooling and judicious by using financial risk protection and cost-burden sharing for those, against high cost of health through prepayment systems.
While the Act establishing NHIS is voluntarily without any compulsion by state governments and employers to join up their employees under the scheme, Sambo called for the restructuring and restructuring in the insurance scheme to meet future challenges whilst the Draft of the completely new NHIS Act has passed second reading at the Hallow Chambers of the Nationwide Assembly.
“Across the world, you will find there's compulsion by citizens to embrace health insurance and in case you cannot afford to pay for your insurance. There is subsidy being paid by the government. Having this amendment inside the constitution spells out what every single tier of government –local, state and federal government- is to purchase those who cannot afford like healthcare insurance platform is essential. This will go a great distance in revolutionizing the healthcare process, Sambo said.
Lending her look at, Adenike Olaniba, national president, Health Providers Association of Nigeria (HCPAN), said that if the scheme would be expanded to produce coverage for more Nigerians inside the informal sector, particularly at your grassroots, there must be a subsidy that will sustain the scheme.
“Enrollees don't pay their premium regularly. Enrollees may pay their premium for around six months and thereafter, the premium will not be forthcoming. How will the process be maintained if nobody subsidises and bridges the gap? If the NHIS would be to penetrate the informal sector and go lower to the grassroots, there has to be subsidy, ” Olaniba explained.
Reference: http://www.healthcoveragestocks.com
