How Oyo is driving Universal Health Coverage in Nigeria through health insurance

In Nigeria, where healthcare costs have soared by 300 percent, access to quality medical services remains a pressing concern for individuals, families, and particularly for the most vulnerable populations. This includes children under five years, the aged, pregnant women, persons with disabilities, etc.

However, amid these challenges, Oyo State is pioneering efforts to drive universal health coverage through its Health Insurance Agency (OYSHIA), ensuring that no one is left behind.

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Olaniyan Magreth, a retired civil servant from Oyo State, was diagnosed with cataracts threatening her eyesight after a routine checkup. Referred from her clinic to a healthcare facility in Basorun, the doctor informed her that the condition required surgical operation.

“The estimated cost of N120,000 needed for the surgery seemed insurmountable on my retirement income,” Magreth expressed her concern. However, the medical team’s understanding and flexibility eased her worries, allowing her to proceed with the operation within a week.

Reflecting on her journey battling cataracts, she acknowledged the importance of timely intervention, crediting the OYSHIA scheme for her access to affordable healthcare.

Magreth’s experience resonates with Adetona Oreoluwa, a civil servant in her late twenties, who described her own experiences with OYSHIA. “Being an enrollee for the past two years has been exceptional,” she said. Oreoluwa recounted accessing dental care, including extractions and regular check-ups, free of charge strain. She also highlighted the scheme’s support for her mother’s arthritis treatment, receiving quality care without worrying about expenses.

Oyo State Health Insurance Agency

Established in 2016 and commencing enrollment in 2017, OYSHIA has extended health insurance benefits to both the formal and informal sectors, with a total enrollment of 190,968 to date (104,533 formal sector enrollees and 86,435 informal sector enrollees).

Speaking at a two-day media dialogue themed “Changing The Narrative on Child Mortality Through Health Insurance,” Olusola Akande, executive secretary of OYSHIA, unveiled the agency’s ambitious goal of enrolling over 500,000 informal lives by the end of 2024.

This endeavour aligns with the agency’s commitment to extending insurance coverage to vulnerable groups, ensuring that they have access to essential healthcare services without facing financial hardship.

“We have been able to scale health insurance in Oyo State through innovative strategies employed such as the ‘Irorun De Plus’ scheme,” Akande said. “Other enrollment packages include the Conventional OYSHIA Scheme, Pensioner’s Scheme, Safer Health, Basic Healthcare Providers’ Fund and Adoption Model, including the Diaspora and Student Schemes.”

One of the key benefits of the OYSHIA scheme is that it reduces out-of-pocket expenses for medical treatment and medication. “For a minimal registration fee and an annual premium as low as N13,500, individuals and families can enjoy comprehensive health coverage, including access to essential drugs, diagnostic tests, consultations, and hospitalisation,” Akande said.

Transforming healthcare facilities and empowering communities

The impact of health insurance in Oyo State is tangible, with several healthcare facilities benefiting from capitation funds. Hospitals have used these funds to construct public toilets, antenatal centres, pharmacies, and even solar-powered facilities.

Additionally, hospitals have been able to employ healthcare professionals and improve service delivery, all thanks to the financial support from the health insurance scheme.

“We renovated eight primary health centres, and two general hospitals and the evidence is there so you will see that health insurance is real and is working in Oyo State,” Akande said. “In a bid to further expand coverage, we are reaching out to underserved communities, including street sweepers, who often go unnoticed. By enrolling over 800 street sweepers, predominantly women, the agency is bridging the gap in healthcare access and honouring the contributions of these essential workers.”

Furthermore, Akande commended the government of Oyo State for its commitment to healthcare, citing the injection of N1 billion into OYSHIA as a testament to the government’s belief in the scheme’s effectiveness. “I thank the government of Oyo State for this intervention,” he said. “Nobody will inject that kind of sum of money into an agency that is moribund or not working.”

Ensuring inclusivity and addressing systemic barriers

In addition to its broader impact on healthcare accessibility, Oyo State’s health insurance scheme is particularly beneficial for vulnerable populations, including pregnant women and children under five.

Akande, noting the importance of ensuring that these groups receive comprehensive healthcare services without financial barriers, said “Pregnant women and young children are among the most vulnerable in our society, and we must prioritize their health needs,”

He advised mothers and children on health insurance, saying, “I want to advise and encourage everyone enrolled in the Basic Healthcare Provision Fund (BHCPF) that it provides free healthcare. The government has paid for it, so we are just enrolling lives. But sometimes, people don’t realize this.

To increase utilization, we provide instant ID cards so you can use them at your facility next week. If someone has paid for your healthcare, please use it. Pregnant women and children under five, please take advantage of the PHCs you’ve enrolled in.”

Looking ahead, Akande stressed the need to deepen service delivery and ensure that enrollees receive the best possible care. He called for a concerted effort to enforce mandatory health insurance and improve service quality across all healthcare facilities nationwide.

Collaborating for a healthier future

In line with its commitment to promoting health insurance among students, OYSHIA has implemented initiatives to reduce out-of-pocket expenses and enhance access to immediate healthcare services. Through philanthropic donations, and partnerships with educational institutions, the agency is building trust among parents and guardians, reassuring them of their children’s well-being.

Despite ongoing investments and commitments from the state government, challenges persist in achieving universal health coverage. However, through collaborative efforts with partners like UNICEF, OYSHIA is spearheading initiatives to address systemic barriers and strengthen health systems.

Ijeoma Agbo, a Health Specialist with UNICEF, at the event, stressed the importance of access to health insurance in achieving universal health coverage. In her address, she called for a multi-sectoral approach involving government agencies, healthcare providers, and the media to overcome existing gaps in coverage and ensure equitable access to healthcare services for all Nigerians.

“When it comes to universal health coverage, we talk about access to health services, including promotive, prevention, treatment, rehabilitation, and palliative care. If you remove financial hardships from families, they will be able to access health services within the facilities.”

Highlighting the role of health insurance as a gateway to universal health coverage, Agbo said “Health insurance ensures that everyone, everywhere, irrespective of socio-economic status or geographical location, will have access to these services.”

She also emphasised the need for state governments to allocate a certain percentage of their budget for health financing. “The National Health Insurance Act, which was brought into law in 2022, makes health insurance mandatory for all citizens in Nigeria,” Agbo said. “It also puts in place the fact that every state has a state health insurance scheme.”

Also, addressing the audience at the training, Blessing Ejiofor, the communication officer, at UNICEF, stated that access to health insurance plays an important role in ensuring that children receive the timely healthcare services they need to survive, thrive and fulfil their potential in life.

She urged the media to become active advocates by using their various platforms to draw the attention of everyone to the issue to bridge the existing gaps in health insurance coverage for vulnerable populations.