The most utilized healthcare facilities by Nigerians are government-owned hospitals (primary, secondary, and tertiary health facilities). Others visit private hospitals (39%) and Pharmacy/Chemist stores (17%), and those who self-medicate (13%) amongst others.
According to the National Health Insurance Scheme (NHIS), the scheme covers less than 5% of Nigerians. The enrollee population in the scheme is largely made up of Federal Government employees and their dependents. Critics have explained that the NHIS has remained abysmal, and coverage rate dropped, from over 10% (5.6 million Nigerians) 10 years ago, to just barely 1.72% (1 million Nigerians) in updated statistics. A 2019 survey by the Lagos Bureau of Statistics revealed that only 11% of household members in the state have their healthcare costs covered by any form of health insurance.
To bridge the coverage gap, several states have launched State Health Insurance Schemes, with about 19 states at various stages of their implementation journey. These schemes typically involve the establishment of a governing agency to oversee the implementation and management of the scheme. They have also defined benefit packages to cater to the most common healthcare occurrences. But access to affordable healthcare continues to be a challenge for most Nigerians due to high levels of poverty and significant reliance on out-of-pocket payments. Health Insurance coverage throughout the country has barely scratched the surface in terms of the nation’s population.
To critically analyse possible changes in the sector, including through the HMOs, Culture Intelligence from RED engaged its 500-member national focus group on their access to health insurance schemes in the country.
Among the participants, who are all between 18–45, about 66% have health insurance coverage while 33.3% do not. Among those who have, 100% secured their health coverage through their workplace contract. Majority of the participants (88.9%) confirmed that they are aware of health insurance schemes and have been engaged by certain brands and 11.1% claim otherwise.