The enactment of the National Health Insurance Authority Act 2022 was hailed by all well-meaning Nigerians as a step in the right direction in Nigeria’s journey to universal health coverage. It was hoped that such a beautiful law should not be left on the shelf, but that targeted and calculated steps be taken immediately to begin its implementation. It is reviewing key steps that have not been taken since Maj. Gen. Muhammadu Buhari agreed to the bill in May 2022. Health insurance for all Nigerians.
The World Health Organization’s definition of UHC means that everyone has access to the health services they need, when and where they need them, without financial hardship. UHC implies a scenario in which all people and communities have access to the health services they need, when and where they need them, without financial hardship. Services referred to include basic health services ranging from promotion to prevention, treatment, rehabilitation and palliative care. Nigeria’s health indicators, including maternal and child health, access to water and sanitation, and life expectancy, do not speak to Nigeria’s status as a major African country. The country is far from the dream of UHC.
An imperative on the road to UHC is improving health financing to increase per capita resources for health services. However, improvements in health financing will not only generate additional resources, but also the efficient use of available resources and the reduction of resources among different population groups in the country, especially among underserved groups. It is recognized that effective and equitable deployment also depends.
The first challenge is that the Governing Council established by Section 4 of the NHIA Act has not been constituted. The functions and powers of the Council are of great importance and fundamental to the realization of the goals and objectives of the new regime established by law. Indeed, without a council, the new policy framework endorsed by the NHIA is of questionable legal validity. However, pursuant to Section 58 of the Act, the repeal of the National Health Insurance Scheme Act shall not affect any rights, privileges, obligations or responsibilities made or received under any prior operation of the statute. It is accepted that there is no Occurred or occurred based on enactment, etc.
The second problem is that a new system of compulsory health insurance has been created by law for everyone. But this is the law in the book, not the law on the street. Not implemented yet. Moreover, the provision of the law in this regard seems inadequate in the context that the law is an order of the sovereign and must be obeyed at the risk of sanctions. What are the penalties? The law does not mention enforcement and sanctions against defaulters. Such large provisions should not have been left to the rules and guidelines of the governing councils and authorities.
A third problem is that compulsory health insurance schemes for all non-vulnerable people may be known only to health insurance professionals, workers and relevant civil society organizations. In fact, the majority of the population near his 98% of the population are unaware of this new regime. Enlightenment, advocacy, awareness creation, education, etc. are therefore essential and relevant to achieving the goals of the new regime and increasing health insurance coverage. But has this mass enlightenment and sensitization started?
The fourth problem is the underutilization of the Vulnerable Groups Fund established by Article 25 of the Act. The Foundation has many sources of funding. The first is a resource derived from the Basic Health Care Provisions Fund, which is more than 1% of the federal Consolidated Revenue Fund, and was apparently activated prior to the enactment of the law. It is a health insurance tax that is not imposed. Given the prevalent negative macroeconomic indicators, it is not clear what individuals, businesses or organizations can afford to pay the additional tax. The third is the Special Intervention Fund, which is allocated by the government and allocated to the fund. This has not yet been implemented and, surprisingly, the 2023 Appropriations Bill does not provide for this. Moreover, the justification for imposing sin taxes, such as a sugar tax on carbonated drinks and higher tariffs on tobacco and alcoholic beverages, would not support healthy obesity and other non-communicable diseases such as diabetes, cardiovascular disease, dental caries and liver disease. related to disease. ,Such. But rather than the proceeds of these sin taxes being targeted at health, they go down a bottomless pit of pooled funds to be spent on anything, including frivolous, inappropriate, wasteful, and sometimes illegal spending. I can.
Where is the database of vulnerable people needed to activate VGF? defined as including those who are poor. To be able to reach this group, authorities and state health plans require a census, a database of people who fall into this category, to be updated annually or regularly at appropriate intervals. I have. Pregnancy is a category that lasts about 9 months, so it should be updated regularly for those who have recently become pregnant and those who have given birth. Also, the under-5 category should allow new entrants and phase out older members. Is there a national or state registry of the elderly and mentally ill? If the answer is affirmative, this record is updated upon death or when the mentally ill regains consciousness. Is there a registry of disabled Nigerians or people with disabilities? The existing registry used by the Ministry of Humanitarian Affairs for cash benefit payments can only identify people in need and not other categories . Also, the effectiveness of the ministry’s register is questionable in that it only includes all poor people.
Next steps include: The Minister of Health should make recommendations without delay to the President, who should form and set up a Governing Council. A large-scale awareness and awareness campaign on the new regime of compulsory health insurance should be launched by the authorities in collaboration with state health insurance schemes. This should be followed by enforcement action in a few months. The Vulnerable Group Fund should be fully activated by an allocation of the Special Intervention Fund and health insurance premiums raised from existing and new sin taxes directed at the Fund. Finally, steps should be taken to initiate an authoritative database of vulnerable people and regularly updated through collaboration with numerous government agencies and civil society.
