There are indications that only 19 states are at different stages of implementing Universal Health Coverages (UHC) through the establishment of health insurance schemes, while 17 states have no plan to join 19 years after the launch of the scheme in Nigeria.

Anambra, Delta and Lagos states have, particularly, made significant progress in enrollment of individuals on the scheme.

In a paper, the Head, Medical Services, Leadway Health, Temitope Falaiye, at a virtual media training organised by the underwriter in Lagos, said Nigeria has spent a small proportion of national income, which is about four per cent of the Gross Domestic Product (GDP) as against the agreed 15 per cent at the 2001 Abuja Declaration on health.

Stressing that out-of-pocket expenditure on health, which stands at 77.23 per cent of total expenditure, is about the highest in Nigeria.

He added that a voluntary National Health Insurance Scheme (NHIS) exists in Nigeria but covers less than five per cent of the population, adding that Nigeria’s informal economy, which accounts for more than 60 per cent of its total GDP, is largely uncovered.

“To bridge the coverage gap, there is a need for states to adopt State Health Insurance Schemes for their workers. Currently, about 19 states are at various stages of their implementation journey. Anambra, Delta and Lagos States have particularly made significant progress in enrollment. Private Health insurance accounts for less than three per cent of the Nigerian population,” he pointed out.

Explaining that there is no one-size-fits-all approach to achieving UHC as strategies will depend on local circumstances, he said improvement requires addressing building blocks of health systems with a proper roadmap from policy, implementation and monitoring.

He listed underfunding and skewed funding allocation in favour of secondary and tertiary care as against primary healthcare as well as poor public financial management as threats to coverage.

“Limited political commitment to health and primary healthcare, poor policy formulation, lack of clarity on roles and responsibilities at different levels of the system, lack of measures to assess the quality of care, lack of confidence in healthcare systems and human resource shortages are among the challenges,” he said.

On recommendations, he said: “At the onset, we analysed the customer journey, identified pain points and deployed targeted solutions to ensure a best-in-class experience for both health providers and clients.

“The growth of the company has been exponential with over 51,000 enrollees spread across the country (inclusive of corporate, retail and NHIS.”