FG Unveils Guidelines For Implementation Of Mandatory Health Insurance Scheme

11th October 2023

In a significant step towards the implementation of the National Health Insurance Authority (NHIA) Act, the federal government has introduced comprehensive operational guidelines for the functioning of the health insurance scheme. The Director-General of the NHIA, Prof. Mohammad Sambo, emphasized the importance of these guidelines, which are necessitated by the NHIA Act (2022) that now mandates health insurance in Nigeria.

Speaking at the official unveiling of the guidelines in Abuja, Prof. Sambo highlighted that the NHIA's operational guidelines offer a framework to promote integration and regulation of health insurance throughout Nigeria. These guidelines are seen as a secondary law that delineates the roles, responsibilities, and obligations of various stakeholders and facilitates the practical implementation of health insurance in the country.

He further stated, "The NHIA Act of 2022 laid the foundation for a transformative healthcare system in Nigeria that genuinely aspires to leave no one behind. No Nigerian should have to choose between their health and financial well-being. For health insurance to be effective, it must extend coverage to vulnerable groups, as mandated by the law."

However, it was noted that Nigeria has not yet achieved its health insurance targets. Before the transition to the new NHIA, the country had a national coverage rate of only between eight and nine percent of the population, which fell short of the intended goal. This was attributed to the high out-of-pocket expenses incurred by families seeking healthcare. The government, in collaboration with key health sector partners, is committed to addressing this issue. The NHIA is a critical step in demonstrating the government's dedication to this cause.

Coordinating Minister of Health and Social Welfare, Prof. Ali Pate, who unveiled the guidelines, emphasized the seriousness of the government's commitment to expanding healthcare access. He set a target for enrolling at least 50 million vulnerable Nigerians within a few years. Pate also highlighted the collaborative nature of the guidelines, developed with input from the public, private sector, civil society, and state governments.

This effort aims to prevent Nigerians from falling into poverty due to healthcare costs. As the guidelines are put into practice, it is expected that more Nigerians will gain access to affordable healthcare, aligning with the objectives set by the administration of President Bola Tinubu. The Basic Health Care Provision Fund (BHCPF) will play a crucial role in ensuring that vulnerable groups receive the necessary support.

The Minister of State for Education, Tanko Sununu, who played a key role in the passage of the NHIA Act 2022, expressed concern about the high rate of out-of-pocket healthcare spending by Nigerians, which is nearly 70 percent. This further underscores the urgency of implementing the NHIA.

The Special Assistant to the President on Health, Salma Ibrahim Anas, commended the NHIA's management for their work on the operational guidelines and noted President Tinubu's commitment to the health and well-being of Nigerians. She stressed the importance of addressing gaps in health governance, aligning with the Coordinating Minister of Health and Social Welfare's Four-point Agenda, and fostering stronger collaboration between the federal and sub-national governments.

Minister of Humanitarian Affairs and Poverty Alleviation, Dr. Beta Edu, underscored the significance of the NHIA in achieving universal healthcare coverage, acknowledging the challenges but expressing optimism that it can be achieved through shared health risk costs.

The NHIA Act of 2022, replacing the 2004 law, acknowledges the decentralized state of health insurance in Nigeria, establishes the Vulnerable Group Fund (VGF), and empowers the NHIA to promote, regulate, and integrate health insurance schemes throughout the country. This represents a critical step forward in the nation's healthcare reform efforts.