Nigeria Medical Insurance
The National Health Insurance Scheme (NHIS) operates under a prepayment system called capitation. Every month, any registered member will receive a bill for money that they owe regardless of whether that person has used the NHIS’s services or not. The amount that each member pays is dependent on his ability to pay, and someone paying significantly less can receive the same level of care as someone who is maybe paying ten times more. The objective of this system is to eliminate any socioeconomic barriers that may be an obstacle to achieving access to a health service. Before, someone of a lower income could not go to the country’s top clinics. With the NHIS, they should be able to.
The NHIS has been heavily criticized for many reasons. One of the factors is that due to a lack of organization and the fact that the NHIS is not mandatory, many states and regional governments are not joining the scheme. The NHIS cannot truly be national and healthcare cannot be accessible to all citizens if some local governments are not a part of the NHIS. Since 2006, the federal government has discussed amending the Act in order to make it compulsory for all regions to join. The fundamental problem lies with the way the government is structured. Nigeria has a three-tier system of government, so what is decided upon at the federal level may not necessarily be accepted by the states. Therefore, Nigeria in practice has 38 different governments, 1 federal, 36 state, and 1 Federal Capital Territory (FCT).
Another major problem with the NHIS is the financial cost. In Nigeria, over 70 percent of people live on less than US$1 a day. People are often not willing to spend an entire day or a large portion of their income on traveling to hospitals that are generally located in urban areas. Furthermore, people just do not trust the system. People are not motivated to join a system that they believe is poorly funded, and where the quality of service is extremely poor.
Nigeria’s healthcare sector also faces a problem that many geographically large countries face: decentralization. Most disease-burdened areas are in the more rural parts of the country. However, less than 10 percent of healthcare facilities are in these areas. The overall lack of other infrastructure such as water, electricity, and schools make it so that healthcare personnel do not want to move to these rural areas. To exacerbate this problem, Nigeria is also suffering from a “brain drain”. This is a problem that countries face when the educated, skilled members of their society immigrate to other countries in search of a better quality of life. Even doctors working in the best hospitals in Nigeria only make about $700 USD a month. In 1995, a census showed that there were around 21,000 Nigerian doctors who were working in the United States alone. This is about equal to the number of doctors who actually work in Nigerian healthcare facilities.
All of these problems have led Nigerians to search for other methods of medical care. Some options have been to turn towards traditional medicine, HMOs, and the black market. Many poor and rural Nigerians still rely on traditional medicine, juju. Although there are many traditional medical providers who do play a positive role in their communities, there are also many false healers. HMOs also have a large presence in Nigeria. Around 7 million Nigerians are registered with a HMO. This provides healthcare for citizens at a much lower cost than private insurances do. Of course, the tradeoff is that there are many restrictions on the hospitals and physicians that they can see. Lastly, the black market also sells medicine, supplies, and vaccines. Unfortunately, the quality of this medicine is highly questionable. This has resulted in many deaths. For example, between 2008 and 2009, around 84 children died of contaminated teething medication.
All visitors and expatriates are able to use the healthcare facilities at a higher rate than locals who are enrolled in NHIS or HMOs. However, the quality of care and infrastructure is significantly lower than that of Western Europe and North America. In 2000, the World Health Organization (WHO) ranked Nigeria as 187 out of 191 countries on the performance of their country’s healthcare system. Travelers and expatriates are strongly advised to purchase an international health insurance plan before entering the country. Rural and urban facilities are unlikely to be able to handle any treatment beyond basic medical services. In the event that a serious injury or illness does occur, evacuation to a different country will be necessary. These expenses are known to be as much as $100,000 USD. It is compulsory to purchase a policy that will cover medical evacuation and transportation costs.
Recommended vaccinations include hepatitis A, typhoid, yellow fever, meningococcus, hepatitis b, rabies, measles, mumps, rubella, and tetanus-diphtheria.
In addition, travelers should also bring diarrhea medicine. Diarrhea is a common ailment of travelers in this part of the world. However, most cases are mild and can be treated with rest and adequate fluids. Nigeria is a malaria zone, so be sure to carry anti-malarial medicine. Travelers should also take care to always use insect repellant and sleep in bed nets. Travelers should also bring sufficient supplies of personal prescription medicines and carry a doctor’s note for those prescriptions.
Nigeria has a Human Immunodeficiency Virus (HIV) infection rate of 1.6 percent. Although this rate is lower than Sub-Saharan Africa, it is higher than the international average. Always be careful to not engage in any behaviors that may put you at a risk of infection.
Pacific Prime can assist you with any travel, or health insurance needs should you decide to travel to Nigeria. We offer professional advice at no cost to you. No matter what your budget is or what your requirements are, our professional consultants can help find a policy that fits you or your group. Our policies can cover a wide range of services including dental, maternity, specialist consultation, transportation, inpatient services, and many more. Please contact us today for a free consultation.