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ITS NO NEWS!!! THE health insurance scheme is yet to gain acceptance in the country, as latest weekly poll results released by NOI polls has revealed that almost eight in 10 Nigerians (79 per cent) do not have access to health insurance.
The poll further revealed that almost 5 in 10 Nigerians (45 per cent) rely on private hospitals/ health care facilities for their health care needs with the Federal Government hospitals (25 per cent) coming a distant second. In addition, poor health care facilities and lack of facilities in some instances were identified as factors responsible for high rate of infant mortality experienced in the country. These are a few of the key findings from the health care system poll conducted on May 13.
In May, ‘Save the Children’, an International non-governmental organisation in its World Mothers’ Day report, stated that out of 176 countries, Nigeria ranked 169th worst place for a child to be born. Its country director, Susan Grant, said the health of mothers determine how their babies would fare in life; adding that about 89,700 babies die same day they were born in Nigeria. Some of the recommendations in the report included strengthening the health system; increased commitments and funding toward the health of mothers and children; and passage and implementation of the National Health Bill (NHB).
The NHB was first presented in 2006 and made its way through various bureaucratic bottlenecks before it was passed by the House of Representatives and the Senate in May 2011. However, the bill did not receive presidential assent due to a number of issues surrounding its content and passage. It has been sent back to National Assembly to commence fresh legislative process and it is regarded as urgent and critical by stakeholders, in order to revive the ailing health care system in Nigeria. Against this background, NOI polls conducted its latest poll on the health care system. It is expected that the results and findings from the poll will highlight the perceptions of Nigerians and stimulate commentary to proffer recommendations to strengthening the country’s health care system.
Respondents to the poll were asked people five specific questions. The first question sought to establish the type of health care facility mainly used by Nigerians. Respondents were asked: What form of health care facility do you personally use? Results showed that almost five in 10 respondents (45 per cent) use private hospitals and health facilities; followed by 25 per cent who use Federal Government hospitals. Furthermore, 13 per cent of the respondents stated that they use state government hospitals and 10 per cent simply use pharmacies/drug stores. Other facilities used included traditional health care (3 per cent), local government hospitals/health centres (two per cent) and faith healing centres (1 per cent).
When results are analysed in greater detail, some variations are highlighted. More female respondents (51 per cent) use private hospitals and health facilities compared to male (38 per cent). Also, the South-West has the highest percentage of respondents that use private hospitals and health facilities (59 per cent), followed by the South-East (55 per cent). The North-West has the highest proportion of Nigerians that use Federal Government hospitals (31 per cent), closely followed by the North-East (29 per cent). The North-East also has the largest proportion of people (17 per cent), which simply visit pharmacies/drug stores when they fall ill. The Northern zones have the most people that use traditional health care, which is barely existent in the Southern geopolitical zones.
Respondents were subsequently asked: Do you have access to any form of health insurance? From the results, almost eight in 10 respondents (79 per cent) answered negatively, indicating that they do not have access to any form of health insurance. On the other hand, 21 per cent answered “Yes” to the question. Furthermore, when analysed across geopolitical zones, the South-East region (26 per cent) has the slight majority of respondents that claim to have access to health insurance, followed by the South-South and North-East with 23 per cent each. Also, female respondents (24 per cent) appear to have a slight edge over male respondents (18 per cent) when it comes to accessing health insurance.
Respondents who said they had access to health insurance were further asked: If yes, what form of health insurance do you have? The overall majority (59 per cent) stated that they had access to the National Health Insurance Scheme (NHIS). This was followed by 35 per cent who said they had access to health insurance via a private Health Management Organisation (HMO) paid by their employer and six per cent who said they had access via a private HMO, but self-funded. The North-West has the highest proportion (83 per cent) of respondents that benefit from NHIS, followed by the North-Central (81 per cent). Also, the South-West has the highest percentage of people (51%) with access to health insurance through their employers; while the South-South (15%) and South-East (12%) have the highest proportion of respondents with private HMO arrangements, which are self-funded.
Next, respondents were asked the following question: Do you believe that Nigeria is one of the worst places to be born because of the rate of infant mortality? The results show that the majority (53%) responded negatively, indicating they disagree that Nigeria is one of the worst places to be born. This is followed by 41% of respondents that answered “Yes” and 6% that were not sure and answered “Don’t Know” to the question.
There were significant differences by gender with the majority of female respondents (60%) disagreeing that Nigeria is one of the worst places to be born, while the majority of male respondents (51%) agree with the statement. Also, the North-Central has the highest number of respondents that agree (53%), while the South-South has the highest number that disagree (63%).
Subsequently, respondents that agreed with the previous question (41% of the total) were asked the following question: If yes, what is mostly responsible for the high level of infant mortality? The majority (38%) are of the opinion that “Poor healthcare facilities” is mostly responsible for the high level of infant mortality. This is followed by 19% that reckon it is caused by “Lack of healthcare facilities” and 17% who think it is caused by “No money to pay for treatment”. Other reasons are “Illiteracy on the part of mothers” (14%) and “Insufficient health workers” (12%).
Looking across the geo-political zones, the North-Central has the highest proportion of respondents (64%) that think poor healthcare facilities are responsible for high infant mortality, while the North-East region has the highest (52%) that think it is because there is no money to pay for treatment.
Finally, respondents were asked the following question: What recommendations do you have to lower infant mortality and ultimately improve the healthcare system in Nigeria? The majority of Nigerians (50%) are of the opinion that the Government should “Provide more healthcare facilities and modern equipment” in order to lower infant mortality and improve the healthcare system in Nigeria. This is followed by 24% who believe the government should “Train and employ more health workers”, 19% who think they should “Educate the public more” and 7% said Government should “Provide free healthcare services”.
In conclusion, the results of this poll have clearly indicated that the majority of Nigerians use private hospitals and health care facilities for their healthcare needs, and do not have access to any form of health insurance. Also, it appears that most Nigerians do not agree with previous findings from International NGOs that Nigerian is one of the worst places to be born because of the high rate of infant mortality. While it is not clear why most Nigerians do not agree with the previous finding, perhaps this highlights perceived triviality on the issue of child mortality. Finally, poor healthcare facilities or lack of healthcare facilities were identified as the main factors responsible for the high rate of infant mortality; with the provision of more health care facilities and modern equipment identified as the key recommendation to stemming the tide of infant mortality.
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