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Persistent NHIS Crises Analysed By Health Minister Isaac Adewole



The poor structure of the Act establishing Nigeria’s Health Insurance Scheme (NHIS) is the major cause of various crises that have trailed the scheme over the years, the Minister of Health, Isaac Adewole, has said.
The minister also linked the inability of the scheme to cover a majority of Nigerians, more than a decade after its establishment, to loopholes in Act.

He insisted the Act should have made health insurance compulsory for all Nigerians.

“The Act made insurance voluntary and that is why we are supporting National Assembly to repeal the Act and put in place a comprehensive package. Let it be comprehensive because it cannot be voluntary. There is a need for review of the Act and it is ongoing.

I can tell you today that no Executive Secretary of NHIS has completed a full term in office without being sacked or suspended, apart from Mohammed Dogo, the pioneer ES, so it’s not just about this administration,” Adewole said.

He noted that social media has made information readily accessible and available. It made things look as if it is only now that these things are happening, it used to happen before. We are asking the presidential panel to take a more holistic look at the NHIS, to review the Act of the scheme.



The Act seems to have given so much power to the governing board,” Adewole noted.

“The governing council, by that Act, was given the power to do whatever is necessary to keep the scheme running. If the council now thinks it is important to do anything to keep the scheme running, nobody can say no,” Adewole said.

That is why we say the Act needs to be revised and be more specific. If you look closely, it is as if the council does almost everything there.

The Act is one of the major issues with the scheme. Why NHIS has not covered majority of Nigerians, is because it is voluntary.

When it is voluntary, it makes people not take it seriously. Our disposition- as Nigerians, (is that) we don’t take our health critical. We don’t even treat our body the way we treat our car.

When we wake up in the morning, you have a car you clean it up, you test the engine oil, you test the water level etc. Many people don’t treat their body as well as they treat their cars.

When it comes to health, nobody wants to pay for health. We all want it free and that is why, for us to make it free, somebody has to pay for it. In the UK, the health insurance is there but it’s being funded, essentially, by taxation. What we need to look at in NHIS is – how do we put more money in health, put more resources together, to take care of every body and ensure maximum coverage?” he said.

While millions of Nigerians remain uncovered, the few enrolled under the scheme are complaining of inadequate service delivery.

Since its establishment 13 years ago, a majority of Nigerians are yet to be covered under the scheme.

The agency said last year that over 90 per cent of Nigerians are not captured under the NHIS.

Many have traced the relative poor coverage to the structure of the scheme, which has been tainted with financial irregularities gone unchecked.

The governing board of NHIS, last October, raised an alarm that the agency is near a “tipping point” and may collapse within the next three years, unless urgent measures are taken.

With a new Act, practitioners in the health sector believe a more efficient way the scheme should function, will be clearly stated.


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