Efforts to expand mandatory health insurance across Nigeria are being hampered by persistent insecurity, funding shortages, bureaucratic hurdles, and rising healthcare costs, stakeholders have warned.
During a panel discussion at the National Health Financing Dialogue in Abuja on Wednesday, Muhammad Safana, Chief Executive Officer of the Katsina State Health Insurance Authority (SHIA), highlighted the challenges facing health insurance programs in the country. Although awareness of health insurance has grown in Katsina since the program’s launch in 2019, affordability and insecurity remain major barriers to achieving universal coverage.
Growing Awareness, but Persistent Barriers
Safana shared that when the health insurance program was first introduced in Katsina, 97.5% of the state’s population had no understanding of what health insurance was. Today, he said, about 35 to 40 percent of residents are now familiar with the concept. However, the issue of affordability remains a significant challenge, as between 80 and 90 percent of those who understand health insurance still cannot afford to pay for services.
Impact of Insecurity on Enrollment Efforts
Insecurity, particularly in rural areas, has further complicated efforts to enroll people in the program. Safana recounted how, during an enrollment drive, his team was forced to withdraw after receiving intelligence about an approaching bandit attack. Tragically, some villagers who had come forward to enroll were later attacked and killed.
Funding Gaps and Rising Healthcare Costs
In addition to insecurity, the program faces significant funding gaps, rising healthcare costs, and a shortage of healthcare workers. Safana noted that to improve efficiency, Katsina developed a capitation control mechanism that allocates the majority of funds to purchasing medicines, with additional provisions for human resources, laboratory supplies, administration, and emergency reserves.
This approach, according to Safana, has helped eliminate frequent stockouts and improved service delivery in state health facilities.
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