AN ASSESSMENT OF THE HEALTH INSURANCE SCHEME IN NIGERIA

AN ASSESSMENT OF THE HEALTH INSURANCE SCHEME IN NIGERIA

ABSTRACT

The research study an assessment of the National Health Insurance Scheme (NHIS) in Nigeria; a case study of Federal Civil Servant in Ondo State. With the following objective, To investigate the history and evolution of National Health Insurance Scheme (NHIS) in Nigeria

  1. To find out the commencement of the National Health Insurance Scheme (NHIS) in Ondo State, Nigeria.

The research work also go a long way showing the historical background of National Health Insurance Scheme (NHIS) in Nigeria.

The study will also enable the citizens of Nigeria to know the types of National Health Insurance Scheme (NHIS) in Nigeria.

The research work will also serve as a reference point and guild line for future researchers, federal workers and the general public.

The study will update the existing body of knowledge on National Health Insurance Scheme (NHIS) in Nigeria.

Both primary and secondary sources of data collection were employed in this study. Furthermore, a self –designed questionnaire was adopted to obtain information for this study. The questionnaire was  designed in two (2) section; A and B section A deals with the socio – economic characteristics of respondents while section B deals with the objectives of the study.

 

TABLE OF CONTENTS

Title Page

Certification

Dedication

Acknowledgments

Abstract

Table of Contents

CHAPTER ONE

1.1     Background of the Study

1.2     Statement of the Problem

1.3     Objectives of the Study

1.4     Justification of the Study

1.5     Scope and Limitation of the Study

1.6     Organisation of the Study

References

CHAPTER TWO

2.1     Literature Review

2.1.1  History/Evolution of National Health Insurance

Scheme (NHIS)

2.1.2  Objectives of National Health Insurance Scheme (NHIS)

  • Types of National Health Insurance Scheme (NHIS)

2.1.4  Implementation of National Health Insurance

Scheme (NHIS)

2.1.5  Operations of National Health Insurance Scheme (NHIS)

In Nigeria.

2.1.6  Achievement of the National Health Insurance

Scheme (NHIS)

2.1.7  Challenges of National Health Insurance Scheme (NHIS)

2.2     Theoretical Framework

References

CHAPTER THREE: RESEARCH METHODOLOGY

3.1     Introduction

3.2     Research Design

3.3     Study Population

3.4     Sampling Technique/Sample Size

3.5     Method of Data Collection /Research Instrument

3.6     Administration of the Instrument

3.7     Method of Data Analysis

References

CHAPTER FOUR: DATA PRESENTATION AND INTERPRETATION

  • Introduction

CHAPTER FIVE: SUMMARY, CONCLUSION AND RECOMMENDATIONS

5.1     Summary

5.2     Conclusion

5.3     Recommendations

References

Bibliography

Questionnaire

 

CHAPTER ONE

1.1     BACKGROUND OF THE STUDY

In 1990, total health spending from less than $ 10 per capital in several African and Asian Countries to more than $ 2,700 per capital in the U.S.A. (World Health Organization, 2009). As a result of this, the ability of government especially in the ‘developing nations, to implement their health policies, strategies programmes and projects has been greatly affected. This chronic under –funding of the health sector makes it increasingly difficulty for their public sector to provide health services for its populace in most part of the developing nations. The achievement of the Millennium Development Goals  (MDGS) is also becoming bleak due to inadequate funding (Adesina, 2007).

In Nigeria, the health government is faced with various challenges – a stagnant mono – cultural economy that depends on crude oil as single export commodity, a rapid population growth, political instability and high rate of unemployment (Adesina, 2007). Hence, the government cannot afford to commit enough money to the health sector which is now faced with the consequence of under – funding decreased efficiency, decreased quality/quantity of service, diminished confidence in public sector health facilities and poor maintenance of equipment. An alternative source of health financing is thus inevitable if our vital health indices in Nigeria will not continue to deteriorate, hence the evolution of the National Health Insurance Scheme in Nigeria. Health Insurance according to Durodola (2010) is a means of spreading the risks of incurring health care cost over a group of individuals and households.

Health care cost are often unaffordable to individuals if they have to pay the full cost of treatment as it occurs Health Insurance is the pooling of resources by groups of individuals to take care of such needs. It entails risk sharing by contributors, thus individuals with higher resources subsidizes those with less and those with low incidence of illness subsidize those who require care more frequently (World Health Organization , 2010). Health insurance is defined as the ability to get health services when required without having to pay fully at the time of need because payment has been made by a fixed regular contribution by the insured ot his/her employer or both (Prepayment plan). The money is pooled by the provider of the insurance to pay for all those needing health care. The other alternative to health insurance is the out of pocket payment at the point of service delivery which has been in Nigeria for decades (Adesina, 2007). “Out of pocket” Payment is the least desirable means of health care financings as it denies access to health care to those who cannot afford to pay at the time of their illness.

Prepayment schemes appear to offer a better health care financing option than “Out of pocket” Schemes. The elimination of “Out of pocket” payment option is the goal of health insurance. Health insurance is now regarded as probably the most common form of financing health care worldwide.

 

1.2     STATEMENT OF THE PROBLEM

          The general poor state of the nation’s health care services, the excessive dependence and pressure on government provided health  facilities, dwindling funding of health care in the face of rising  cost, poor integration of private health facilities in the nation’s health care delivery system and overwhelming dependence on out – of – pocket expenses to purchase health was the problem militating against the health sector in Nigeria (Olanrewaju, 2011).

According to the World Health Organization (2005). Nigeria was ranked 197th out of 200 nations. Life expectancy was put at 48 years for males and 50 years for females; while Health Life Expectancy (HALE) for both sexes was put at 42 years. In HALE estimation, Nigeria only ranked higher than five countries; sierra Leone, Afghanistan, Zimbabwe, Zambia and Lesotho.

The WHO (2005) report further states that Nigeria accounts for 10 percent of global maternal mortality figure, with 59, 00 women dying annually from pregnancy and child birth. It adds that for every maternal death, 30 others suffer long term disabilities while 40 percent (about 800,000) of global obstetric fistulas occur in Nigeria.

The frightening report also states that the health situation in the country has been so deplorable because only 39 percent of births are delivery by skilled health professionals. It also states that the risk of a woman dying from child birth is 1 in 18 in Nigeria compared to 1 in 61 for all developing countries and 1 in 800 in developed countries, adding that only 23 percent of children (12 – 23 months) receive full course of immunization against childhood killer diseases (Olarenwaju, 2011).

However, reducing child and maternal mortality rates are part of the Millennium Development Goals (MDG) which the government is committed to. It     targets a reduction of the mortality of children under the age of five by two –third between 2000 and 2015, that is, from 207 in 2000 to 67 by 2015, in the same vein MDG also targets a 75 percent decline in maternal mortality rate by 2015, that is from 704 in 2000 to about 176 in 2015.

It is therefore, obvious that unless there is a quick intervention, Nigeria will get to 2015 without a change in her health status. That is where the National Health insurance Scheme (NHIS) comes in.

 

1.3     JUSTIFICATION OF THE STUDY

          The research work will go a long way to showing the historical background of National Health Insurance Scheme (NHIS) in Nigeria.

The study will also enable the citizens of Nigeria to know the types of National Health Insurance Scheme (NHIS) in Nigeria.

The research work will also serve as a reference point and guild line for future researchers, federal workers and the general public.

The study will update the existing body of knowledge on National Health Insurance Scheme (NHIS) in Nigeria.

The study will enable the general public  to know the achievements of National Health Insurance Scheme (NHIS) in Nigeria.

Lastly, the work will reveal the problems facing the National Health Insurance Scheme (NHIS) in Nigeria.

 

1.4     OBJECTIVES OF THE STUDY

          The broad objective of this research study is to give an assessment of the National Health Insurance Scheme (NHIS) in Nigeria; a case study of Federal Civil Servant in Ondo State. From the broad objective, the specific objectives drawn are;

  1. To investigate the history and evolution of National Health Insurance Scheme (NHIS) in Nigeria
  2. to find out the commencement of the National Health Insurance Scheme (NHIS) in Ondo State, Nigeria.
  3. To identify the types of National Health Insurance Scheme (NHIS) in Nigeria.
  4. To evaluate the achievements of National Health Insurance Scheme (NHIS) on Federal civil servant in Nigeria.
  5. To determine the challenges of Nationa Health Insurance Scemen (NHIS) in Nigeria.

 

1.5     SCOPE AND LIMITATION OF THE STUDY

The research study intends to give an assessment of the National Health Insurance Scheme (NHIS) in Nigeria. The study will be limited to the Federal civil servant in Ondo state due to costs, time constraint and administration of the research instrument.

 

1.6     ORGANISATION OF THE STUDY

          This study is divided into five (5) chapters. Chapter one deals with the background to the study, statement of the problem, objective of the study, justification of the study,  scope and limitation of the study, organisation of the study and operational definitions of terms.

Chapter two deals with the literature review and theoretical frame work for the study.

Chapter three deals with the research methodology, which include the research design, study population, sample size/sampling technique, method of data collection/research instrument, administration of the instrument and method of data analysis.

Chapter four deals with the presentation and interpretation of data.

Chapter five deals with the summary, conclusion and recommendations.

This Project is is available for the below list of Nigerian State capitals.
Abia Umuahia, Adamawa Yola, Akwa Ibom Uyo, Anambra Awka, Bauchi Bauchi, Bayelsa Yenagoa, Benue Makurdi, Borno Maiduguri, Cross River Calabar, Delta Asaba, Ebonyi Abakaliki, Edo Benin. Ekiti Ado Ekiti, Enugu Enugu, Gombe Gombe, Imo Owerri, Jigawa Dutse, Kaduna Kaduna, Kano Kano, Katsina Katsina, Kebbi Birnin Kebbi, Kogi Lokoja, Kwara Ilorin, Lagos Ikeja, Nasarawa Lafia, Niger Minna, Ogun Abeokuta, Ondo Akure, Osun Oshogbo, Oyo Ibadan, Plateau Jos, Rivers Port Harcourt, Sokoto Sokoto, Taraba Jalingo, Yobe Damaturu, Zamfara Gusau, FCT Abuja.

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