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[INSIGHT] How Nigeria botched plan to cover 24 million pupils with health insurance

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BETWEEN 2014 and 2015, the National Health Insurance Scheme (now the National Health Insurance Authority, NHIA) severally pledged to provide coverage for 24 million pupils in public primary schools in Nigeria.

But the promise has not come to fruition over six years after, and there is no proof the organisation still pursues the goal.

The initiative was one of the programmes the NHIA intended to launch during the administration of its former executive secretary, Femi Thomas, as part of the country’s efforts to achieve universal health coverage, and thereby reduce out-of-pocket healthcare spending for citizens.


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Thomas headed the NHIA from November 2013 to April 2015, when former President Goodluck Jonathan sacked him.

His administration also targeted enrolling the National Youth Service Corps (NYSC) members in the health insurance scheme.

It took the government about six years to make that plan a reality.

President Muhammadu Buhari ordered the inclusion of NYSC members in the scheme, according to the immediate past NYSC Director-General, Brigadier General Shuaibu Ibrahim, who revealed the development to journalists in January 2022.

Other programmes initiated by the Thomas administration were mobile health insurance and provision of free health services for pregnant women and children under five years.

In April 2015, former President Goodluck Jonathan sacked Thomas over alleged infractions and appointed Olufemi Akingbade, the General Manager, ICT in the organisation, to head the NHIA in acting capacity.

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Enrolment of the pupils also failed to sail through under subsequent executive secretaries of the organisation, namely Usman Yusuf, a professor and the current head, Mohammed Sambo, also a professor. 

Like Thomas, Yusuf was booted out by Buhari in July 2019 over allegations of corruption and high-handedness, among others. 

Buhari had appointed him in August 2016. 

Since it took off in 2005, the NHIA has yet to cover 10 per cent of Nigerians, according to multiple reports.

Enrollees, dominated by government employees, have complained of poor services across health facilities.

The ICIR contacted the Head of the Public Relations Unit of the NHIA, Emmanuel Ononokpono, on Sunday, who confirmed there had been no health insurance coverage for school children, except for those paid for by their parents.

“We have a programme called GIFSHIP (Group, Individual and Family Social Health Insurance Programme). It is for everybody in Nigeria. As long as you pay, you get coverage.”

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Asked whether the government had fulfilled its promise to enrol the 24 million pupils, Ononokpono said: “I am giving you the current situation in which we have GIFSHIP programme that covers every other person.”

The ICIR reports that nearly 40.8 million pupils between the ages of six and 11 are in public primary schools, according to the 2018 National Personnel Audit by UBEC, the most recent data on basic schools in the country.

The United Nation’s Children’s Fund (UNICEF) data show that about 10.5 million children are out of school in Nigeria, the highest globally.

Experts have blamed the high population of out-of-school children on issues including insecurity, poverty, accessibility and the inability of poor families to combine health care and other needs of their children with tuition, among others.

However, the new NHIA Act, signed by Buhari in May 2022, does not stop the institution from pursuing the ambition and others that will boost health insurance coverage in the country.

The Act, which makes health insurance mandatory for all residents in Nigeria, empowers the NHIA to work with state governments and other relevant stakeholders to promote insurance coverage for the nation’s population.

In June, The ICIR highlighted key issues in the NHIA Act.

The Sustainable Development Goal Three, Target Eight, seeks to achieve Universal Health Coverage for all by 2030.
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