More than three-quarters of Nigerian adults do not have health insurance cover, a recent survey conducted by NOIPolls Limited, a public opinion and research organisation shows.
The opinion poll conducted in the week commencing August 30th, 2021, involved telephone interviews of a proportionate nationwide sample of 1,000 randomly selected phone-owning Nigerians aged 18 years and above, representing the six geopolitical regions and 36 states and the FCT of the country.
A breakdown of the survey shows that the 77 percent is a decline of six and five percentage points when compared to the previous results of 83 percent (2019) and 82 percent (2017) respectively, while the 18 percent who have health insurance is an increase of three percentage points from 15 percent (2019) and 11 percentage points from nine percent (2017)
According to NOIPolls, this implies that the coverage of health insurance has remained abysmal despite the National Health Insurance Scheme (NHIS) which was established in 2006 to achieve Universal Health Coverage (UHC) in Nigeria with financial risk protection mechanisms.
“Fifty-seven percent of adult Nigerians who pay out-of-pocket to access healthcare are willing to pay money monthly or yearly to get enrolled into the health insurance scheme,” NOIPolls stated in the survey report.
It adds that this further provides evidence that access is a major issue concerning health insurance across the country.
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Evidence shows that some healthcare expenditures can push people further into poverty.
According to the World Health Organisation, about 100 million people are pushed into extreme poverty each year because of out-of-pocket spending on health. “Over 930 million people spend at least 10 percent of their household income on health care.”
Damilola Adewale, a Lagos-based economic analyst said many poor people cannot access basic healthcare services because they cannot afford it.
“Higher out-of-pocket expenditure impose an additional burden on low-income households because their available resources are not sufficient to meet food and shelter demands, not to talk of health,” He further said.
Africa’s biggest economy’s surging inflation rate pushed seven million Nigerians into poverty. According to the World Bank, before inflation started rising steadily, there were 82.9 million poor Nigerians but the number has risen to 90.1 million.
NHIS is a body established under Act 35 of the 1999 Constitution by the Federal Government of Nigeria to improve the health of Nigerians at an affordable cost.
It seeks to provide social health insurance in Nigeria where health care services of contributors are paid from the common pool of funds contributed by the participants of the scheme.
Further analysis of the survey revealed that artisans (93 percent), farmers and agricultural workers (91 percent), religious leaders (89 percent), self-employed traders (88 percent), businessmen and women (88 percent), Youth corps members (86 percent) and unemployed (84 percent) are among households and individuals that are paying out-of-pocket and incurring catastrophic health expenditure to access healthcare services in the country.
“Government workers/ civil servants (51 percent), and professionals, mainly workers in private organisations, (30 percent) top the list of individuals who access health insurance in the country,” It highlighted.
In terms of geographical location, health insurance coverage rates are highest in the North-West zone (24 percent) whereas it is lowest in the South-East zone (14 percent).
To increase health insurance coverage and reduce the incidence of out-of-pocket payments, NOIPolls calls for a determined and deliberate approach towards mass enrolment of Nigerians by relevant stakeholders as well as intensive sensitization as 47 percent disclosed that they are not aware of the NHIS.
“It is gratifying that at least seven Nigerian States have signed health insurance laws to help in achieving equitable and sustainable health financing mechanisms. Functional state health insurance schemes will help increase the pool of individuals with health insurance thereby driving down premiums,” It added.
