Hospital policies

Healthcare Services Delivery in Nigeria

Henry Oshoremoh
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The quality of healthcare service delivery under the existing health maintenance organisations (HMOs) in Nigeria has been a major concern to enrollees who have contested the value received from their respective HMO accredited hospitals under the program. We appraised health maintenance organisations’ performance in the Nigerian healthcare service sector capturing enrollees’ experience on the issues of access, responsiveness, and quality of healthcare service choice to measure the success or failure of the program since inception. Findings revealed that HMO accredited hospitals have not ensured adequate access of enrollees to healthcare services, their responsiveness to enrollees’ healthcare requests have not been impressive, and quality of healthcare services to enrollees have also not been excellent.

Good health remains one of the basic needs of individual irrespective of status in the society. This is the reason why government as a major stakeholder in any society considers the issue of health as critical and fundamental. To achieve this, government in different countries has different programs and policies to deliver qualitative healthcare system to her citizenry. Healthcare is the totality of various activities carried out to maintain optimal functioning of the individual, treatment of pathology, and the promotion of health of individuals with or without pathology. In spite of the importance of a healthy living to society, accessing good-quality healthcare services has been incredibly poor in developing countries. For Nigerians, accessing good-quality healthcare services at affordable rate has been difficult due to decay in public health institutions and expensive charges in privately owned hospitals.

One of the healthcare intervention programs in Nigeria was the introduction of National Health Insurance Scheme (NHIS) backed with Act 35 of 1999 under which Health Maintenance Organisation (HMO) was set out to address observed short fall in the quality of healthcare service delivery. The scheme is jointly financed by employer and employee who is an enrollee. The HMO model was borrowed from developed countries and treated as limited liability companies. In Nigeria, HMOs are licensed by the National Health Insurance Scheme (NHIS) to facilitate the provision of healthcare benefits to contributors.

Recent development revealed that enrollees have concerns about the value derived from the HMO programs. This observation seems true with the Nigeria low ranking in global healthcare index which covered 1990–2015 involving 195 countries placed Nigeria 187th in healthcare service delivery.

A strong indication of this was obvious when twenty-three (23) HMOs in the country by National Health Insurance Scheme governing council on 5 April 2018 seemed to make the fears of enrollees about the performance of HMOs true.

Read: How Long Can You Stay on Your Parent’s Health Insurance?

 


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