1.1 BACKGROUND OF THE STUDY
Nigeria, like most other developing nations, implemented various initiatives aimed at achieving high living standards for its people at the time of independence in 1960. Up to the early 1980s, several construction plans were conceived and implemented. However, because of the uncertainty in the national political structure, the intended results of these steps were not optimally realized. The military's sporadic inroads into politics guaranteed the perversion of the ability of the people to live a decent life. Thus, economic mismanagement and oppressive governance witnessed the era (Ajakaiye, Taiwo and Chete, 2017).The mismanagement meant that the citizenry's abject poverty and low economic status contributed to the emasculation of most citizens and thereby increased the divide between rich and poor.Nigeria has historically ranked among the least in the quality of life assessment of population under the Human Development Index (HDI) of the United Nations Development Programme (UNDP).By the early 1990s, nearly all social services had declined, according to Agbakoba (2012). The health sector is one area of the economy that has struggled heavily. The World Bank (2010) estimates that Nigeria's per capita health investment was not only poor, but low in quality in the early 1990s. Nigeria's health spending of US$9 per person was much lower than in some other African nations, including Ghana (US$14) and Kenya (US$16). The net result of this was that child mortality was 11.4% in Nigeria in 1990, compared to 7.4% in Ghana and 5.7% in Kenya. Thousands of Nigerian infants have been malnourished and have been exposed to killer diseases such as measles, polio, whooping cough and diphtheria in the absence of sufficient immunization (Ehusani, 2012). The World Health Organization exposed the pitiful image of Nigeria's health sector, noting that the overall performance of the country's health system in 2000 was ranked 187th among the organization's 191 member states.(WHO, 2011).High child and maternal mortality and the prevalence of illnesses, many of which were of epidemic proportions, were the result of this. Malnutrition, iodine deficiency, low birth weight and stunting occurred. Life expectancy dropped to 48 years and the health-for-all illusion became a mirage by 2015. The condition in the sector was so serious that Dr. Agan, Chief Medical Officer, University Teaching Hospital, Calabar, observed that the distribution of health care in Nigeria was dead. (Vanguard, May, 17, 2012). Nigeria has one of Sub-Saharan Africa's lowest health care provider-to-patient ratios: 0.3 Doctors per 1000 people, 1.7 hospital beds per 1000 people, 1.7 Nurses, 0.02 Dentists, 0.05 Pharmacists, 0.91 Community Health Workers and 1.7 midwives per 1000 people, respectively. (WHO,2016; Ogbolu2012).
Health insurance stands for a pooling of health costs in order to secure coverage for the participants regardless of the confusion underlying the prevalence of ill health and compensation for the care of that ill health. This is because, while it is predictable for big populations, the demand for health insurance is also extremely unexpected and very expensive for the client. It is possible to use premiums to distribute the premium load. In a number of forms, health care may be funded and coordinated. It can be acquired by a person or organization from profit or non-profit companies in the private sector and, under these cases, it is conventionally considered private or charitable health insurance.In general, compulsory insurance is administered by state bodies, although it can be administered by private insurance carriers, as is the case in the Netherlands with respect to civil servants. Community health insurance is a sub-type of universal health insurance that is typically part of a social welfare scheme financed by specific donations (mainly payroll) and operated by independent or quasi-autonomous sickness trusts, friendly societies or private insurers.In the other hand, optional (private) health care may be approved and paid for on behalf of people at the discretion of individuals or employers. Voluntary insurance can be sold, as is the case in Ireland, by a public or quasi-public body. Customers, manufacturers and third party financial institutions are the primary parties to the health insurance system (insurers). How they relate to each other determine the insurance plan. Depending on a country's concept of provider, providers include medical physicians, pharmacists, nurses, and other allied health professionals. Insurance agencies, illness trusts, charitable or quasi-public organizations, health maintenance organizations (HMOs) and friendly associations are third party financiers.
The Nigerian health care sector is an innovative driver that creates and widely disseminates modern, life-enhancing therapies and provides a wide variety of health care customer options. There are major advantages to the existing health care system, but there are tremendous possibilities for changes that will decrease prices, expand coverage, improve efficiency and improve the health of Nigerians.In several ways, the health of an individual can be sustained or enhanced, both by improvements in personal conduct and through the adequate consumption of health care services. Although there is tremendous spending on health care in Nigeria, the value of health gives a good justification for this amount of expenditure. However, since funding and delivery of health care are often inefficient, there are ways to improve health and access to health care services without further increase in spending.The Administration has adopted initiatives that will raise options for people to buy consumer-directed health insurance premiums in order to boost the effectiveness of health care funding and delivery.
The Administration has also sought to connect compensation from providers to results, thus rewarding successful health care delivery. In Presidentspeech, he suggested a reform in the tax status of health insurance, proposing a standard allowance for the purchase of health insurance for all Nigerians. Such a move may play an important role in strengthening the effectiveness of the Nigerian health care system and growing health insurance coverage. Health care has enhanced the health of our society not just through the utilization of health care facilities, but also through individual actions and lifestyle decisions such as avoiding smoking, consuming more nutritious foods, and having more exercise; better productivity in the health care system, however, could result in even greater health for Nigerians without increasing health care spending, Rapid growth in health care costs and limited access to health insurance continue to present challenges to the health care system.Administrations policies are aimed at reducing cost growth, increasing coverage and widening access to health care by relying on the private sector and market-based solutions. The need for health care is different from the demand for other consumer goods and services, since primary use is the need for consumer products and services, the desire for health care is not derived directly from the consumption of the medical procedures themselves; rather, it comes from the direct value of improved health that is produced by health care
In Nigeria, the influence of health insurance is being eroded by a failing economy. Health insurance impacts the customer's financial power, health status, and others, so it is important for people in Nigeria to be covered because it can help minimize the cost of disease treatment, improve access to health services, etc. This research focuses on the impact of insurance on health care services in Nigeria.
1.2 STATEMENT OF PROBLEM
1.3 OBJECTIVE OF THE STUDY
In line with the statement of research problems the objectives of the study are to determine the impact of insurance on health services in Nigeria
1) To examine the evolution of health insurance scheme in Nigeria
2)To examine the impact of health insurance on health services in Nigeria
3) To examine the forms of health insurance obtainable in Nigeria
4) To determine the prospects and challenges of health insurance in the delivery of health care services in Nigeria
5) To recommend solutions to the problems of health insurance in achieving a reliable health service in Nigeria
1.4 RESEARCH QUESTIONS
1) What is the evolution of health insurance scheme in Nigeria?
2) What is the impact of health insurance on health services in Nigeria?
3) What are the forms of health insurance obtainable in Nigeria?
4)What are the prospects and challenges of health insurance in the delivery of health care service in Nigeria?
5)What are the solutions to the problems of health insurance in delivery of a reliable health service in Nigeria?
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