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HIV RESOURCING USING HEALTH INSURANCE POLICY
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Around the world, National Health Insurance Scheme (NHIS) has become an effective tool in financing health care needs of the very vulnerable people in the society. The rich are made to assist the poor buy contributing to a pool of funds and the government equally contributes into this pool of funds for affordable health care delivery system.

The National Health Insurance Scheme (NHIS) is a body set up under Act 35 of 1999 by the Federal Government of Nigeria, to improve the health of all Nigerians at an affordable cost through various prepayment systems. Nigeria under the former President Olusegun Obasanjo formerly launched the NHIS contributory scheme in 2005. So far, the system has worked for some people especially those in the Federal and state civil service and some organized private sector. Testimonies of beneficiaries of the scheme are loud and clear, among which is that of a 37 years old civil servant, Adamu Ali who works in one of the ministry’s in Abuja. Adamu who said his wife delivered twice using NHIS platform and having to pay a token (10% of the total hospital cost after delivery) was full of joy stating “this is the first time my country will give me assistance, it was like a dream when I was asked to pay N4,000 from the total N40,000 bill my wife incurred during child birth in a faith based hospital”. There are several positive testimonies likewise are negative ones ranging from delay in attending to NHIS patients, limited numbers of aliments covered under the scheme, stigma attached to using NHIS as patient are made to form a separate queues away from other patients, bureaucracy involved in getting dependents registered on the scheme and so other limitation being experience in the scheme.

NHIS coverage in the country is currently less than 10% of the entire Nigerian population and this are mainly people in the formal sector while those in the informal sectors are hardly covered under the scheme and this is a major issue the new Executive Director Prof. Usman Yusuf is battling at the moment. If our health care delivery coverage must increase significantly, more Nigerians must be enrolled in to the scheme and this can only be done if there is sincerity of purpose especially among the NHIS staff, government at all levels (federal, states and LGAs) and constant engagements with organized private sectors.

On the part of the Health Maintenance Organizations (HMOs) who have contributed their fair share into the problem confronting the scheme, it has been alleged that the HMOs despite drawing millions from the government coffers delays payment to hospitals engaged to provide healthcare services to contributors of the scheme thereby making these hospitals provide inefficient services to patients under NHIS.  In some instance the HMOs and the retainer hospitals collide to inflate numbers of enrollees or amount incurred all aimed at short changing the system which in turn affect the beneficiaries.


At this point in Nigeria’s HIV National response, the resources available to fight HIV continues to dwindles as foreign donor agencies are either cutting down or stopping in totality aids to Nigeria. The Director General of NACA Dr. Sani Aliyu has continue to stress the need for the NHIS scheme to become more effective than it is at the moment has it has the capacity to include among the many packages currently offered to patients, HIV prevention, care and treatment services. Dr. Aliyu said since the cost to treat one patient is known and the cost to run necessary laboratory test is equally known to NACA, efforts are on the way to work in collaboration with NHIS as an agency to work out modalities to include HIV services in NHIS package as this will not only fast forward the realization of the much talked about ownership and sustainability of HIV response in the country.
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