National Health Insurance Scheme (Prospects And Problems)
(A Case Study of National health insurance scheme)
The National Health Insurance Scheme (NHIS) presents promising avenues for enhancing healthcare accessibility and affordability, yet it also confronts significant challenges. On the positive side, the NHIS fosters inclusivity by providing a mechanism for citizens to access essential healthcare services without experiencing financial hardship. By pooling resources, it spreads risk across a broad population base, promoting equity and social justice in healthcare provision. Additionally, the scheme encourages preventive care and facilitates early intervention, potentially reducing the burden on the healthcare system. However, several issues impede its effectiveness. Insufficient funding jeopardizes the scheme’s sustainability and limits its capacity to cover a wide range of services. Administrative inefficiencies, including bureaucracy and corruption, hamper the smooth operation of the NHIS, leading to delays and inequities in service delivery. Moreover, public awareness and understanding of the scheme’s benefits and enrollment processes remain inadequate, hindering its uptake among eligible beneficiaries. Addressing these challenges requires concerted efforts from policymakers, healthcare providers, and the public to ensure the NHIS realizes its full potential in improving health outcomes and promoting social welfare.
The intention of this research is to analyse the prospect and problems of National health Insurance scheme in Nigeria. Which will bring health care for all? In analyzing this topic I will give a brief introduction on how the scheme works and states the prospect and problem. Also a guideline will be drawn how the scheme will react in Nigeria now it has been established and lunched. How the problem will be solved.
The review of some other literature words on the subject matter “National health insurance scheme” the meaning and in detail the evaluation f health insurance in Nigeria.
I will also look into the problems associated with National health insurance the benefit or the scheme. Its role and methods of operation.
FINALLY: I will give a run down on how the researcher concluded his research work, the method and design used while work, the method and design used while undertaking the research. Also present and analysis the data obtain and draw a befitting judgment based on the responses received from the population sample, interviewed and how people react to the subject matter NATIONAL HEALTH INSURANCE SCHEME.”
Approval Page
Dedication
Acknowledgement
Abstract
Chapter One
1.0 Introduction
1.1 Background Of The Study
1.2 Statement Of The Problem
1.3 Purpose Of The Study
1.4 Significance Of The Study
1.5 Scope And Limitation Of The Study
1.6 Definition Of Terms
Chapter Two
2.0 Literature Review
2.1 What Is Health Insurance
2.2 The Meaning Of National Health Insurance Scheme.
2.3 National Health Insurance In Nigeria
2.4 The Role And Benefit Of N.H.I.S In Nigeria
2.5 The Problems Of N.H.I.S In Nigeria
2.6 Solution To The Problems Of N.H.I.S
Chapter Three
3.1 Research Design And Methodology
3.2 Source Of Data
3.3 Method Of Investigation
Chapter Four
4.0 Data Presentation And Analysis
Chapter Five
5.1 Summary Of Research Finding
5.2 Recommendation
5.3 Conclusion
Bibliography
Appendix
1.0 INTRODUCTION
This research work is a protection into the future of National health insurance scheme; financing through insurance in Nigeria. This work will serve as a survey on how Nigerians in general will react towards the operation of National health insurance scheme. Many researchers have made numerous proposals on how the scheme should be operated, but now the scheme has started. It will be proper to examine the market reactions, acceptability and its effect on the economy.
Moreover since the Logan “health care for all by the year 2000” is within its reality, it is felt that for such to be achieved, National health insurance scheme should take place. And the government, ministry of health and the general public should control the scheme. It has been noted that health insurance is more advanced and modern alternative to the tax-financed.
Nat with standing, this work gave a view of what National health insurance is, its forms, its benefits and other important aspects that will put a layman through on what National health insurance is. It was noticed that as government has taken up the scheme, it will encounter a lot of challenges and difficulties. This research work included recommendations on how the government could subdue such difficulties and challenges of health are delivery.
1.1 BACKGROUND OF STUDY
Since 1981 when the Nigerian medical Association held a conference in Calabar and Dr. E.M Umez Sroums delivered aa paper on “National health insurance” A practical approach to health care financing in a developing economy. He said that there has been growing need for National health insurance scheme in Nigeria. This issue has engaged the attention of medical doctors, insurance executive, the federal government of Nigeria, and Nigerian Newspapers which have carried a member of headlines on the topic.
But now the scheme has become a reality. The federal government lunched the scheme on 6th June 2005. Base on the establishment of the scheme, the purpose of providing health insurance which shall entitle insured persons and their dependents the benefit of prescribed good quality and cost effective health services as set out in this Decree. That is Decree of 2000. The body established for the management of the scheme are:
A governing council which shall subject to the decree, which has general control of the scheme. The council shall consist of the following members:
The chairman who shall be appointed by the head of state. Commander in chief of minister of health. Others are: each person to represent ministry of health, fiancé, government of the federation, Nigeria labour congress, N.E.C.A, private health care provided to carryout a research on this subject in order to highlight the problems militating against the scheme or problems which the scheme will face. Its prospects and make recommendations which will ensure the success of the scheme here in Nigeria.
1.2 STATEMENT OF THE PROBLEMS
A lot have been done by various groups and bodies in order to come up with a benefiting scheme that will achieve an effective goal of health care for all Nigerians, which has been in highlights of government programmes.
There are problems that night hinder the effective national health insurance scheme in Nigeria.
i) Inadequate public Enlightment on the need for national health insurance service.
ii) The population of Nigerians did not welcome the scheme
iii) Non introduction of phase by phase structurally scheme.
iv) Its marketing strategies and means of operating the scheme
v) Non support of masses in response to the scheme for seminar.
In order to improve health care delivery system in Nigeria; the researcher must ensure that this research will problems that might hinder the effective National health insurance scheme in Nigeria.
1.3 PURPOSE OF THE STUDY
Based on the problems surrounding the scheme. This work will examine.
i) How far insurance industry has gone in seeding to the effective of National health insurance scheme in Nigeria.
ii) The out come of various committees established to make that National health insurance scheme to be a successful one in Nigeria.
iii) To know the peoples reaction and market acceptability of the scheme.
iv) To recommend through these research work proper guidelines and means which the scheme will operate in our country for a complete market acceptance by all Nigerians.
1.4 SIGNIFICANCE OF THE STUDY
This projects will be of great importance to all Nigerians who for long shares same view that our Nation Nigeria need to adopt a health care insurance that will fair of loss cost, efficient and effective in the administration and operation.
However, on more pronounce detail, this study’s importance on individual basis that will be of help if its recommendation are adopted to facilitate the immediate acceptance of National health insurance by all, it will create health care finance awareness on a model way which will encourage personal contribution of ideas fiancé and materials towards ensuring a good health care delivery to all.
Organization, institutions and business entities who spent huge amount of money for there employees and families for health insurance will becomes operational in Nigeria. This will be achieved of such scheme is adopted in line with the research recommendation and the little amount saved will be channeled to other profitable venture.
Nigerians will also fire the study beneficial, if the guideline and recommendation are adopted in establishing National health insurance scheme in Nigeria which will obtain its health for all by the scheme.
The health sector will witness efficiency the scheme will eliminate corruption indiscipline, fraud and ensuring death reduction from, all health, this in variable will lead to an increase in Nigeria citizens due to in improving bur artic and depressed health care delivery system will on establishing National health insurance scheme will fined Nigeria a worthy place to live and their money.
1.5 Scope and limitation of the study
This work for easier understanding and implementation covers all analytical research aimed within the country for the establishment of health insurance including the held since 1990 till date for the establishment of National health insurance scheme. As National health insurance scheme has introduced now there are some problems that its prospects and problems that its prospects and problems in the economy. During the project some problems faces the research they are:
Financial constraint
Time constraint
Knowing how the public will react as the scheme has been introduced today.
To identifying the suitable type of National health insurance in operating such scheme.
How to engage a massive support from all Nigerian if the response to the scheme is now.
Its marketing strategies and means of operating such scheme.
Those problems as mentioned will be relayed in details how each a constraint to this research work.
Financial contrant
Due to lack of enough fund, the researcher could not meet all required financial obligations which the work demands, this never, resulted to a few limitations.
Time constraint
As we know time is never on anyone’s side, so it was a constraint to our research work because there was other programmes such as examination quiz and other academic works which fell exactly within the period of our research work and all these programmes plus the research demanded till the same and equal attention.
1.6 Definition of terms
i) Insurance company: A company registered or demand to be registered under the companies and Allied Matter Decree of 1997.
ii) Health: It is a sound of bodily or mental condition of a person.
iii) Health insurance: The ability to get health services when required without having to pay fully at the time of need either because payment has previously been made by regular contributions by the insured or his/her employer or both.
iv) Health care delivery: The act or process of administering effective medication and hospitalization to sick people in a community at a reduce rate.
v) Capitation: Registered payment on personal basis to a doctor for giving health service to a person concerned when necessary.
vi) National health insurance scheme: It is a body corporate established under Act 35 of 1999 by the federal government of Nigeria to improve the health of all Nigeria at an affordable cost.
Prospects And Problems Of National Health Insurance Scheme:
The National Health Insurance Scheme (NHIS) is a healthcare financing program that aims to provide financial risk protection and improve access to quality healthcare services for citizens in many countries. While the specific details and challenges of NHIS can vary from one country to another, I can provide you with a general overview of the prospects and problems associated with such schemes based on common trends and challenges observed in healthcare systems around the world.
Prospects of National Health Insurance Schemes:
- Universal Healthcare Access: NHIS programs aim to provide healthcare coverage to a broader segment of the population, potentially leading to universal healthcare access, where everyone has access to essential healthcare services regardless of their income or socioeconomic status.
- Financial Protection: NHIS can offer financial protection to individuals and families by reducing out-of-pocket expenses for medical care. This helps prevent catastrophic health expenditures that can lead to poverty.
- Improved Health Outcomes: With better access to healthcare services, NHIS can contribute to improved health outcomes by facilitating early diagnosis and treatment of illnesses, reducing mortality rates, and enhancing overall well-being.
- Efficiency and Cost Control: NHIS can promote efficiency in healthcare delivery by pooling resources, negotiating with healthcare providers for cost-effective services, and implementing measures to control healthcare costs.
- Preventive Care: These schemes often emphasize preventive care and health promotion, which can lead to a healthier population and reduce the burden of chronic diseases.
Problems and Challenges of National Health Insurance Schemes:
- Funding Shortfalls: One of the primary challenges faced by NHIS programs is securing adequate and sustainable funding. Many countries struggle to maintain the necessary funding levels to provide comprehensive coverage for their populations.
- Administrative Complexity: The management and administration of NHIS programs can be complex and resource-intensive. Overly bureaucratic systems can lead to inefficiencies, delays, and increased administrative costs.
- Quality of Care: While NHIS can increase access to healthcare, it doesn’t always guarantee the provision of high-quality care. In some cases, cost-saving measures may lead to a focus on quantity rather than quality of services.
- Fraud and Abuse: NHIS programs are vulnerable to fraud and abuse, both by healthcare providers and beneficiaries. Fraudulent claims and overutilization of services can strain the financial sustainability of the program.
- Inequities: Achieving equity in healthcare access remains a challenge. NHIS programs may not fully address disparities in access to care among different socioeconomic groups or in rural vs. urban areas.
- Political and Policy Changes: Changes in political leadership and policy priorities can lead to instability and fluctuations in funding and support for NHIS programs, making it difficult to sustain them over the long term.
- Healthcare Infrastructure: The success of NHIS often depends on the availability and capacity of healthcare facilities and professionals. Inadequate infrastructure and a shortage of healthcare workers can hinder the delivery of quality care.
- Economic Challenges: Economic downturns and recessions can strain the financial resources needed to support NHIS programs, making it difficult to maintain coverage levels during challenging economic times.
- Public Awareness and Education: Lack of public awareness and understanding of NHIS can lead to low enrollment rates, undermining the program’s ability to achieve its goals.
In conclusion, National Health Insurance Schemes have the potential to significantly improve healthcare access and financial protection for populations, but they also face several challenges that need to be addressed for their long-term success. These challenges often require a combination of effective governance, sustainable funding mechanisms, and continuous monitoring and adaptation of the programs to meet evolving healthcare needs.