Background:

Accessibility to quality and affordable healthcare services in Nigeria remains a major problem. Many Nigerians struggle to access quality care and/or struggle to pay for the medical bills. The National Health Insurance Scheme (NHIS) was established to provide easy access to affordable healthcare services for all Nigerians through various prepayment systems. However, since its implementation in 2005, the NHIS provides coverage to less than five percent of the population. Several states in Nigeria have implemented their own health insurance scheme aimed to ensure that its residents have access to quality healthcare services, without suffering financial catastrophe.

Following the introduction of their health insurance scheme, one of Nigeria’s largest states enlisted Vesta Healthcare to support the State Government in drafting the legislation of the Health Insurance Management Agency responsible for the promotion, operation and regulation of the new health insurance scheme in the State.

Approach

Learning from the implementation of NHIS, Vesta Healthcare collaborated with key stakeholders and ensured that the roles of all relevant healthcare practitioners were specified in the operational guidelines for the Health Insurance Management Agency. The Health Insurance Management Agency will regulate, supervise and ensure the effective administration of the new scheme.

Vesta Healthcare worked closely with the State Ministry of Health, State House of Assembly, International Development Institutions, and other relevant stakeholders in drafting the legislation and developing a detailed implementation plan.

As part of the advisory committee, Vesta Healthcare provided support on technical issues to the Minister of Health on the development of the policy and legislation for the successful implementation of the health insurance scheme. This included introducing an equitable health financing system, where enrolees paid according to their ability to pay and received benefits based on their health status. Vesta Healthcare played a leading role in the development of the health funding strategy by creating the Health Fund and designing the financial flows within the new scheme.

The final draft Bill was reviewed intensively to ensure the rigorous and continuous monitoring of the implementation of the scheme. Vest Healthcare provided recommendation for improvements that would ensure it produced an efficient operational structure to promote and regulate health insurance in the State.