Prompted by Stakeholders, Nigeria Releases Stalled Funds and Further Commits to Improving Health Insurance Programming
Late in 2018, Nigeria’s Federal Capital Territory (FCT) Health Insurance Scheme broke new ground, holding its first ever stakeholders’ meeting—a move which led to the eventual release of nearly US$1.4 million in stalled funds and new political commitments by some of the FCT’s top leaders.
A Ground-Breaking Event
In November, healthcare providers, beneficiaries, and civil society and health maintenance organization representatives gathered to examine the implementation of the health insurance scheme since its roll-out in 2011. They also aimed to generate lessons to improve the scheme’s implementation, thereby providing greater access to high-quality healthcare for the FCT’s estimated 2.2 million people.
In the lead-up to the meeting, co-organizers Health Policy Plus (HP+) and the FCT Health Insurance Scheme, took steps to ensure broad participation. The two held community sensitization events to mobilize citizens, ensured adequate representation from the informal sector, and reached out to private sector health providers and health maintenance organizations to discuss financial, management, and technological challenges.
During the meeting, FCT Secretary of Health and Human Services, Adamu Bappah, said, “We are aware of the challenges facing the scheme in the FCT and hope the lessons we generate from this meeting helps us with solutions to address this.” FHIS Program Manager, Dr. Ahmed Danfulani, noted that the meeting was an opportunity, “to take stock of what we have done correctly, identify challenges and what we need to do moving forward.”
At the meeting’s conclusion, stakeholders agreed that the FCT Health Insurance Scheme would need to take the following steps to improve implementation:
- Deploy information communication technology to enhance transparency.
- Expand population coverage to avoid a small pool and ensure sustainability.
- Solicit the continuous support of the FCT Minister, Secretary of Health and Human Services Secretariat, and Director of Treasury to ensure the prompt release of funds to the agency so it can carry out its projects.
Advocacy Leads to Action
Three days after the meeting took place, the FCT Director of Treasury released 350 million Naira (US$972,000) for payment of outstanding capitation to healthcare providers. The original request had been made six months prior. Also, 150 million Naira (US$417,000) was approved by the FCT Minister for fee-for-service payments owed to providers since 2017. The government also committed to settling all remaining overdue payments by the end of 2018 and paying all first quarter 2019 payments in advance. HP+ Nigeria and its partners are hard at work monitoring the progress of these commitments.
Moving the Needle
Going forward, HP+ will continue to build on the efforts it began in 2018, working with the health insurance scheme to improve its Legislative and Governance Framework and move FCT health insurance legislation through the National Assembly. HP+ is also supporting the FCT Health Insurance Scheme to access funds from the Basic Health Care Provision Fund, develop strategies for enrolling informal sector beneficiaries, and strengthen information communication technologies and the management of claims. One part of this support is the development of a demand-generation strategy targeting the informal sector and area councils. Inclusion of area council staff, who are 17,000 strong, could increase the scheme’s premium paying enrollees by 85%, enlarging the overall pool and providing high-quality healthcare for more FCT residents.