THE BENEFITS OF MEDICAL INSURANCE ON HEALTH CARE SERVICES IN NIGERIA.

CHAPTER ONE

INTRODUCTION

1.1 Background Of The Study

The contribution of the health care sector to national development remains a critical concern. In Nigeria, health care services are deemed unsatisfactory and insufficient in addressing the requirements and desires of the people, as evidenced by the population's poor health. According to Irinoye, (2016), it is reasonable to suggest that some of the fatalities and major diseases that occur among Nigerians are caused by situations that may be readily avoided with easy solutions. In the course of mild diseases, a lack of early and adequate care frequently raises the risk of significant consequences  Even in times of financial constraint, the current high incidence of illness and death may be significantly decreased by a more logical utilization of existing resources (Irinoye, 2015).

To respond to the situation, various reform programmes have been implemented, and the administration has stated its willingness to undertake a bold system overhaul. The government has developed and executed a National Health Policy in an effort to guarantee that all citizens achieve a condition of perfect physical, mental, and social well-being. The National Health Policy and Strategy for Health for All Nigerians was implemented in 1988 and amended in 2004. Care Resources, National Health Interventions and Services Delivery, National Health Information Systems, Partnership for Health Development, National Research, and Health Care Laws are the key policy thrusts of the National Health System.

Despite a well-structured health system, the growth of Primary Health Care (PHC) has not benefited the health of the people, particularly those living in rural regions.  As a result, as part of the government's effort to solve the sector's challenges, the National Health Insurance Scheme (NHIS) was launched to address Nigeria's health concerns. The National Health Insurance Scheme (NHIS) is a corporate organisation formed by the Federal Government of Nigeria under Act 35 of 1999 to enhance the health of all Nigerians at an affordable cost. Health insurance is a strategy that prevents insured individuals from incurring significant medical expenditures during a period of illness. A client pays a regular payment to a management institution as part of the basic health insurance process. This organisation is in charge of depositing money into a fund and paying a healthcare provider for the cost of the consumer's care (Conn and Walford, 1998). According to NHIS data from 2011, 5% of the population is enrolled in the plan (NHIS 2012b). The majority of people included work for the federal and state governments and reside in cities (Lawan, Iliyasu, and Daso 2016). However, more than 60% of Nigerians work in the informal sector and survive on less than $1 a day in rural regions (as cited by UPI, 2012). They cannot afford excellent quality health care because they lack sufficient financial means when faced with health difficulties thus the need to resort to other private medical insurance.

Medical insurance is often meant to considerably provide for the welfare of citizens, particularly the least fortunate in society (Kutzin 2017). Out-of-pocket (OOP) health finance remains substantial, accounting for about 95.3% of private health expenditure (PvtHE) in 2010 (PvtHE as a proportion of Total Health Expenditure (THE) was 62.1% in 2010), and has a disastrous effect on the poor. Many Nigerians have died as a result of their failure to satisfy this demand (Lawan  2017). In essence, this would provide access to treatment while mitigating financial risk. The system has been in place since 2005, with the goal of reaching universal health coverage by 2015. Based on the foregoing, this study seeks to determine the impact of national health insurance on Nigeria's elderly inhabitants.

1.2 Statement Of The Problem

In recent times, Nigeria has a life expectancy of 52.3 years, which is lower than the African average of 56.05 years, and infant and maternal mortality rates are alarming. Despite the federal government's attempts to enhance healthcare service, Nigeria's health indices have either stagnated or worsened during the last decade. As observed by Dika (2019) every year, one million children under the age of five die, the majority from neonatal causes, malaria, and pneumonia. Maternal mortality is 630 per 100,000 live births, comparable to that of low-income nations such as Lesotho and Cameroon. HIV infects an estimated 3.3 million Nigerians due to limited access to prevention, care, and treatment. Lawan 92017) posits thaat whereas most Nigerian do not have opportunity to enjoy national health insurance, most of them have resort to private medical insurance even as Nigeria is likewise dealing with the dual burden of communicable and noncommunicable illnesses.

Whereas the National Health Insurance Scheme (NHIS) medical insurance is an endeavour by the Nigerian federal government to offer universal health coverage (UHC) to its inhabitants,   Dutta and Hongoro (2018) asserts that private sector medical insurance has been more effective and ensures all people' access to and usage of high-quality health-care services, as well as protection for all persons from any catastrophic financial impact of illness. Gustafsson-Wright and Schellekens (2018) asserts that  medical insurance provide both access to health services and financial security, such as avoiding out-of-pocket costs that limit service affordability and, ideally, some reimbursement for productivity loss due to sickness. Although there have been various studies on the benefits of medical insurance, less emphasis has been made to its influence on health care services in Nigeria. Upon this backdrop, the study seeks to examine the benefits of medical insurance on health care services in Nigeria.

1.3 Objectives Of The Study

The overall aim of this study is to critically examine the benefits of medical insurance on health care services in Nigeria.. Hence, the study will be channeled to the following specific objectives;

i.          Investigate the level of awareness of  health insurance scheme among Nigerians.

ii.        Determine whether medical insurance scheme contribute to health-related welfare of  common Nigerians.

iii.      Ascertain whether medical  insurance scheme improve the quality of live of aged Nigerians.

iv.      Ascertain whether national health insurance scheme gives access to health services and financial protection to Nigerians.

1.4 Research Question

The study will be guided by the following questions;

i.          What is the level of awareness of   health insurance scheme among Nigerians?

ii.        Does national health insurance scheme contribute to health-related welfare of aged Nigerians?

iii.      Does national health insurance scheme improve the quality of live of average Nigerians?

iv.      Does national health insurance scheme give access to health services and financial protection to average Nigerians?

1.5 Significance Of The Study

The significance of this study is to highlight the ineffectiveness of aging programs and services in Nigeria, with a view to advocating changes in policy formulation and implementation of health programs and services so as to affect the elderly population. Currently, there are no overt programs and services for the elderly in Nigeria because there has not yet been a policy for the care of seniors in Nigeria. This paper will as well make advocacy for the establishment of such facilities in order to better the lot of the elderly population in Nigeria.  Additionally, subsequent researchers will use it as literature review. This means that, other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regards to the impact of National health insurance scheme on average citizens of Nigeria.

1.6 Scope Of The Study

This study is structured to generally examine the impact of National health insurance scheme on aged citizens of Nigeria. However, the study will further investigate the level of awareness of medical insurance scheme among average  Nigerians, determine whether national health insurance scheme contribute to health-related welfare of average Nigerians, ascertain whether national health insurance scheme improve the quality of live of average Nigerians, and ascertain whether national health insurance scheme gives access to health services and financial protection to average Nigerians. The study is however delimited to selected resident of Ibadan Metropolis in Kwara State.

1.7 Limitation of the Study

During the process of carrying out this study, the researcher was confronted with a number of obstacles, some of which were limitations pertaining to time and finances, as well as difficulties pertaining to language and the attitudes of the respondents. Nevertheless, the researchers were able to overcome these obstacles in order to guarantee the success of this investigation.

In addition, the case study approach that was used in the research presented the investigator with a number of difficulties, such as the chance of making erroneous judgments and being subject to prejudice. In spite of this, the investigator was successful in overcoming the difficulties by adhering to the broad principles of respect for processes, justice, fairness, impartiality in observation and recording, and the weighing of evidence.

1.8 Definition of Terms

NHIS: National Health Insurance Scheme.

UHC: Universal Health Coverage.

PHC: Primary Health Care.

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