The National Health Insurance Scheme (NHIS) in Nigeria: current issues and implementation challenges

Abstract

The National Health Insurance Scheme (NHIS) in Nigeria, despite its critical role in aiming for Universal Health Coverage, faces significant challenges. Initiated in 2005 with the goal of universal healthcare access by 2015, the scheme has struggled with low enrolment rates, fluctuating numbers of healthcare professionals, and substantial out-of-pocket expenditures for citizens. Current statistics indicate less than 5% of Nigerians are enrolled in NHIS, while 70% still finance their healthcare independently. Major issues include inefficient service delivery, inadequate healthcare infrastructure, and poor resource management, leading to substandard care quality. Recommendations for improvement focus on enhancing hospital efficiency, motivating and retaining healthcare workers, adopting appropriate technology, and clarifying prepayment mechanisms. Increased state contributions and robust evaluation metrics are also suggested to facilitate better adaptation to Nigeria's diverse and growing population. Addressing these challenges is crucial for achieving the intended goals of the NHIS and moving closer to universal health coverage in Nigeria. Extensive discussions and strategic policy adjustments are essential to overcome these barriers, ensuring effective healthcare service delivery and financial protection for the Nigerian population.