The National Health Insurance Scheme (NHIS) established by Decree 35 in 1999, though signed into law then, didn’t become operational until June 6, 2005 when it was officially launched. Nigeria’s National Health Insurance Scheme, now operating under the National Health Insurance Authority (NHIA), was established to make quality health care affordable and accessible to every Nigerian. While the scheme has expanded over the years and increased enrolment across the country, many beneficiaries say gaps in implementation continue to undermine its objectives. Investigations by Weekend Trust show that although thousands of Nigerians now enjoy subsidised health care through the scheme, many still struggle with shortage of essential medicines, delayed referrals, inadequate information about their benefits, long waiting hours and out-of-pocket payments for drugs and medical investigations. ‘Our plight’ For many enrollees, the realities inside hospitals differ sharply from the promise of affordable health care. AKK: 6 years, multiple deadlines, no gas Jostle for deputy gov’ship slots intensifies as INEC opens portal today Abigail Chukwudi recalled registering for delivery at a federal medical facility under the NHIS and fulfilling all the necessary requirements, including ensuring that her husband donated blood ahead of childbirth. But according to her, despite meeting the conditions, she was informed while in active labour that there was no available bed space. She alleged that repeated requests for medical attention and referral were ignored until her condition deteriorated and she insisted on being transferred elsewhere. She said she was eventually referred to another hospital but the process lacked proper coordination. According to her, the receiving hospital was not adequately briefed about her condition, while payments made at the first facility were not recognised. As a result, she said she had to purchase delivery materials again, pay fresh hospital bills and even make another payment for blood she believed had already been covered. She added that none of the money paid at the initial hospital was refunded. Another beneficiary, Ada Ikenna, described her experience during childbirth as equally frustrating. She alleged that nearly every drug, laboratory investigation and scan required during treatment was declared outside the NHIS package, forcing her family to make repeated payments. “When I had my son, the extortion was very high. Honestly, it was a very bad experience for me. I would say the NHIS does not exist in that hospital. We were extorted,” she said. She said a similar experience occurred during the birth of her second child. “Literally, everything they said the NHIS did not cover. ‘Go and pay for this, go and pay for that.’ When you push further and say, ‘But this card is from the NHIS.’ They will insist you pay. We kept paying until we spent more than N300,000,” she alleged. Another enrollee, Yunusa Hadiza, said the scheme remained useful for routine health care but fell short whenever specialised treatment is required. She cited delays in obtaining approval from HMOs before certain procedures could be carried out, warning that such delays could be dangerous during emergencies. “In emergencies, patients are often left on their own because approvals take too long,” he said. Hadiza also observed that while private hospitals generally provide faster services, some are reluctant to fully accommodate NHIA patients because of concerns over reimbursement, forcing beneficiaries to spend additional money despite being insured. Ezeh Daniella, a trader enrolled under a community-based insurance programme, said although the scheme helped reduce her medical expenses, she still paid for some laboratory tests. For an entrepreneur, Gbenga Azeez, the greatest challenge remains bureaucracy. “You go from one desk to another before you finally get attention,” he lamented. Some enrollees have decried poor access to essential medicines and inadequate emergency care in hospitals under the National Health Insurance Scheme (NHIS) despite the Federal Government’s huge investments in the scheme. Other enrollees, who spoke to our correspondent in separate interviews in Abuja, expressed mixed reactions over the quality of healthcare services given, saying while some hospitals provide satisfactory treatment, while others are plagued by persistent shortages of drugs and other challenges. A federal civil servant, Emmanuel Antswen, said his experience under the scheme had improved significantly after transferring from a government-owned health facility to a private hospital. He said although no healthcare system is perfect, he is satisfied with the quality of care he currently receives. “I receive good services. While nothing is perfect in Nigeria, I am grateful for the quality of care and services I have received. “I must also state that before I transferred from a gover
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