National Health Insurance Scheme (NHIS) :Outcomes From Insight

Constituted under act 35 of 1999 by the Federal Government of Nigeria, the National Health Insurance Scheme (NHIS) was officially flagged off by former President Olusegun Obasanjo, in June 2005.

The social security initiative came in response to their yearnings and aspiration of millions of Nigerians who found find it difficult to cope with the health-financing structure in existence.

In a country like Nigeria where over 70 percent live below $1 a day, it was clear that there was need to provide easy access of health care to all Nigerians at an affordable cost.

At its flag-off, many Nigerians some of whose situation were so bad that they could not afford going to hospitals heaved a sigh of refile because the Government promised that the NHIS had come to stay.

Not only has the scheme come to stay, it has also given Nigerians a valid reason to believe in the Federal Government’s commitments to their well being.

Notable, evidence continued to mount across the country that millions of Nigerians have been enjoying the full advantages of the numerous opportunities Offered by the scheme.

However, the primary objectives of the National Health Insurance Scheme is ensuring that every Nigerian has easy access to good heath care service.

This is by making sure all Nigerians are ultimately registered with the scheme, it also seeks to protect families and individuals registered under it from very expensive medical bills.

Under this, an individual dose not have to panic over the cost of his or her medical treatments because NHIS sends money at regulated intervals to the Health Maintenance Organization (HMO) on behalf of registered person whether such persons visit the facility of their choice or not.

This is known as capitation, and it comes from contribution of employees in the formal sector which are earning based.

Another objective of the scheme is to ensure qualitative health care services delivery to all Nigerians.

This is why the scheme maintains strict guidelines and requirement for all participants on board.

To ensure efficiency in health care services, the scheme regulates and monitors the activities of the accredited Health Maintenance Organization and Health care providers.

Furthermore, it aims to incorporate the private sector, being a major employer of labor in the country, in the provision of the health care services.

It also insist on quality, not mere participation as the yardstick of relevance in the health insurance process.

Participation is optional except for workers in the public and private sector who will contribute 5 percent of their basic salary to the scheme while their employers pay 10 percent for each worker, which entitles a contributor, his or her spouse and four biological children to access medicare from their chosen service provider.

Companies and employers will have to register their in-house medical centers as health service providers which would eventually earn money for the centers and save money in the form of medical bills for the companies.

Under the Urban Self-Employed Social Health Insurance Program those who chose to participate would;


Identify and belong to a socially cohesive group of more than 500 members which most be occupation based.

Make a monthly payment of between N120-150 for the most common ailment like malaria, typhoid, fever, diarrhea, etc.

Only need to present an NHIS registration card to an accredited health care provider to receive medicare.

Participation under the Rural Community Social Health Insurance Program requires similar procedures, except that participants need not to belong in same occupational group but must belong to same community. 

Meanwhile, the Formal Social Health Insurance Program incorporates workers in the public and private sectors and is mandatory for any organization having ten or more employees.

Cost is spread equitably, contributors chip in five percent of their basic salary, while employers pay ten percent to the common pool.

This entitles a contributor, a spouse and for children to full health benefits.

The Urban Self-employed Social Health Insurance Program on the other hand, is deigned for individuals who are self-employed, urban dwellers in the informal sector and other members of socially cohesive groups will make flat rate contributions regularly to derive health benefits as mutually determined by members base on their needs.

The Rural Community Social Health Program then again, covers Nigerian’s rural folks who constitute over 70 percent its 150 million population.

The pregnant women and U-5 children’s program as well as the Permanently Disabled Persons Social Health Insurance Program, among others will be under the direct management of the NHIS, unlike the earlier mentioned three to be administered each by an independent Board of Trustees to be elected from the ranks of contributors.

The there is the person inmates Social Health Insurance Program design a cater for convicted persons in prisons and remand homes nationwide.

Nevertheless, the National Health Insurance Scheme since inception has continued to be applauded from both within and out side the country.

This is in recognition and appreciation of the laudable archive it continues to record even in the face of daunting challenges.

It is important to note that Nigeria is one other very few countries in the world to have registered so many beneficiaries in such few years of existence - over six million Nigerians are registered with the NHIS already.

The Maternal and Child Health Project (MCHP), introduced by the scheme, in collaborator with the MDGs office of the presidency, has been able to carter for about one million pregnant women, nursing mothers and children under five in twelve states across the country, in a project that is design to ultimately cover the enter country.

This project has been commended by international agency interested in the country’s attainment of its MDGs goals.

I one of such commendations, USAID noted that “already the project has produced significant benefits to its targets population and communities in which they live.”

The construction an ultramodern building as medical center by the Federal Polytechnic, Bida Niger state is also a pointer in the practical demonstration of the NHIS’s resolve to strengthen health care infrastructure.

The building constructed at a cost of fifty-six million naira, will cater for over nine thousand students of the school registered preparatory to the commencement of the scheme’s Tertiary Institutions Social Health Insurance Program (TISHIP) this year.

With the success recorded in the registration of over 90 percent of Federal Civil Servants/uniform service personal and their families, the National Health Insurance Scheme is determined and focus on archiving even greater success in the organized private sector as part of its formal sector program.

Thus blueprints for the Tertiary Institution Health Insurance, Retiree Health Insurance and Voluntary Contributions’ Health Insurance Programs are ready.

The NHIS dose not fail to sanction erring stockholders in its drive to archive its set goals. To show its seriousness in dealing with defaulters, Ayodele Medical Center Ilorin, was recently at the reliving end of the scheme’s punitive action.

To the scheme, compliance with rule and regulation cannot be compromised if the trust of Nigerians is to be sustained.