ORIGINAL ARTICLES Comparing the Nigeria National Health Insurance Scheme Act, 2004 and the National Health Insurance Authority Act, 2022 - What is New and its Implications for the Health System

West Afr J Med . 2023 May 27;40(5):525-532.

Abstract

Abstract  in English, French

Background: Currently, <10% of Nigerians are insured by the National Health Insurance Scheme (NHIS) and this among other things has led to the signing of the National Health Insurance Authority (NHIA) Act in May 2022, which aims at ensuring the effective implementation of a national health insurance policy and attainment of Universal Health Coverage (UHC) in Nigeria.

Objective: To highlight the new features of the NHIA Act and its policy implications for the Nigerian health system.

Methods: A modified Delphi method was used for extracting the differences in the two Acts. A total of three rounds of reviews were carried out among 5 reviewers within three weeks. Differences were tabulated and also presented in prose.

Findings: The NHIA Act makes health insurance mandatory for all residents of Nigeria with the introduction of the vulnerable group fund and implementation of the Basic Health Care Provision Fund through the established State Health Insurance Schemes. Unlike the NHIS which is a Scheme, the NHIA is an Authority and has an expanded function to regulate, promote, manage and integrate all health insurance schemes and practices in Nigeria. Also, funds management has been transferred from Health Maintenance Organizations to the State Health Insurance Schemes and the Health Maintenance Organizations are now excluded from the Governing Council.

Conclusion: Certainly, the journey towards UHC could be safer and more equitable with health insurance now mandatory for all Nigerians and the introduction of vulnerable group funds in the new Act. This will eliminate the catastrophic expenses of poor Nigerians if the Act is correctly implemented.

Keywords: Health Insurance; Health System; NHIA; NHIS; Nigeria.

T M Ipinnimo ¹, A A Omotoso ¹, T A Bamidele ¹, T A Sanni ^1 2, D O Ibirongbe ³, M T Ipinnimo ⁴, O O Ibikunle ⁵