THE IMPACT OF HEALTH INSURANCE SCHEME ON THE AGED CITIZENS OF NIGERIA

CHAPTER ONE
INTRODUCTION

Background Of The Study: Health services are deemed unsatisfactory and inadequate in addressing the public's requirements and demands, as evidenced by the population's poor health (FMOH, 2022). It is plausible to assert that some of the fatalities and major diseases that occur among Nigerians are attributable to situations for which easy solutions exist. Lack of prompt and effective care frequently heightens the risk of significant consequences from simple illnesses (Irinoye, 2022). Even in times of financial constraint, the current high rates of illness and death can be significantly decreased by a more logical utilization of existing resources (Irinoye, 2022).

Various reform schemes have been implemented, and the administration has indicated its intent to undertake a radical system overhaul. The government has created and executed National Health Policy in an effort to guarantee that every person achieves a condition of perfect physical, mental, and social health. The National Health Policy and Strategy to attain health for all Nigerians was implemented in 1988 and amended in 2004.

Care Resources, National Health Interventions and Service Delivery, National Health Information Systems, Partnership for Health Development, National Research, and Health Care Laws comprise the primary policy focus of the National Health System. Despite a well-structured health system, Primary Health Care (PHC) development has not benefited the health of the population, particularly in rural regions. The contribution of the health sector to national development remains a critical concern. As a result, as part of the government's effort to solve the difficulties in the sector, the National Health Insurance Scheme (NHIS) was established to address Nigeria's health issues. The Federal Government of Nigeria created the NHIS under Act 35 of 1999 in order to promote the health of all Nigerians at a reasonable cost. Health Insurance is a strategy that prevents insured individuals from incurring excessive medical expenses during an illness. A client pays regular payments to a management institution as the foundation of the health insurance procedure. This entity is responsible for storing payments in a fund and paying the consumer's healthcare provider for the cost of service (Conn & Walford, 2022).

The 2011 NHIS data indicate that 5% of the population is registered with the system (NHIS 2012b). The majority of individuals included work for federal or state governments and reside in metropolitan regions (Lawan, Iliyasu, & Daso 2012). Nonetheless, over sixty percent of Nigerians belong to the informal sector and live in rural regions on less than one dollar a day (as cited by UPI, 2022). When confronted with health issues, individuals cannot afford high-quality medical care because they lack sufficient financial means. Out-of-Pocket (OOP) funding of health remained high at around 95.3% of the private spending on health (PvtHE) in 2010 (PvtHE as a percentage of Total Health Expenditure (THE) was 62.1% in 2010), and often has a disastrous effect on the poor. Numerous Nigerians have perished as a result of their failure to satisfy this demand (Lawan et al, 2022). NHIS is often intended to considerably promote the welfare of citizens, particularly the disadvantaged members of society (Kutzin, 2022). In essence, this would ensure access to treatment with protection against financial risk. The program has been in effect since 2005, and the deadline for obtaining universal health coverage was 2015. This research seeks to determine the effect of Nigeria's national health insurance on senior persons.

1.2 Statement Of The Problem

Despite the federal government's attempts to enhance healthcare delivery, Nigeria's health indices have either remained stable or declined during the previous decade. Nigeria's life expectancy of 52 or 53 years is lower than the African average of 56,05 years, and its infant and maternal mortality rates are staggering. One million children die annually before reaching the age of five, primarily owing to neonatal causes, malaria, and pneumonia. Comparable to low-income nations such as Lesotho and Cameroon, the rate of maternal death is 630 per 100,000 live births. An estimated 3.3 million Nigerians are infected with HIV, yet prevention, care, and treatment are scarce. In addition, Nigeria continues to tackle both communicable and noncommunicable illnesses.

The National Health Insurance Scheme (NHIS) is the federal government of Nigeria's attempt to implement universal health coverage (UHC) for its inhabitants. UHC is defined by Dutta & Hongoro (2022) as the provision of access to and utilization of high-quality health care services for all people, as well as the protection of all persons from catastrophic financial effects of illness. According to Gustafsson-Wright & Schellekens (2022), UHC refers to health systems that provide both access to health services and financial protection, including the avoidance of out-of-pocket payments that reduce the affordability of services and, ideally, compensation for productivity loss due to illness. In this study, the term "aged citizens" refers to all Nigerians aged 50 or over. This research seeks to determine the impact of health insurance scheme on the aged citizens of Nigeria.

1.3 Objectives Of The Study

The overall aim of this study is to critically examine the impact of National health insurance scheme on aged citizens of Nigeria. Hence, the study will be channeled to the following specific objectives;

1. Investigate the level of awareness of National health insurance scheme among aged Nigerians.

2. Determine whether national health insurance scheme contribute to health-related welfare of aged Nigerians.

3. Ascertain whether national health insurance scheme improve the quality of live of aged Nigerians.

4. Ascertain whether national health insurance scheme gives access to health services and financial protection to aged Nigerians.

1.4 Research Question

The study will be guided by the following questions;

1. What is the level of awareness of National health insurance scheme among aged Nigerians?

2. Does national health insurance scheme contribute to health-related welfare of aged Nigerians?

3. Does national health insurance scheme improve the quality of live of aged Nigerians?

4. Does national health insurance scheme give access to health services and financial protection to aged Nigerians?

1.5 Significance Of The Study

The significance of this study is to highlight the ineffectiveness of aging programs and services in Nigeria, with a view to advocating changes in policy formulation and implementation of health programs and services so as to affect the elderly population. Currently, there are no overt programs and services for the elderly in Nigeria because there has not yet been a policy for the care of seniors in Nigeria. This paper will as well make advocacy for the establishment of such facilities in order to better the lot of the elderly population in Nigeria. 

Additionally, subsequent researchers will use it as literature review. This means that, other students who may decide to conduct studies in this area will have the opportunity to use this study as available literature that can be subjected to critical review. Invariably, the result of the study contributes immensely to the body of academic knowledge with regards to the impact of National health insurance scheme on aged citizens of Nigeria.

1.6 Scope Of The Study

This study is structured to generally examine the impact of National health insurance scheme on aged citizens of Nigeria. However, the study will further investigate the level of awareness of National health insurance scheme among aged Nigerians, determine whether national health insurance scheme contribute to health-related welfare of aged Nigerians, ascertain whether national health insurance scheme improve the quality of live of aged Nigerians, and ascertain whether national health insurance scheme gives access to health services and financial protection to aged Nigerians. The population of this study covers residents in Ilorin west local Government Area Ilorin, Kwara state.

1.7 Limitation Of The Study

In the course of carrying out this study, the researcher experienced some constraints, which included time constraints, financial constraints, language barriers, and the attitude of the respondents. However, the researcher were able to manage these just to ensure the success of this study.

1.8 Definition Of Terms

NHIS: National Health Insurance Scheme.

UHC: Universal Health Coverage.

PHC: Primary Health Care.