Nigerians have now heaved a sigh of relief with the passage of the National healthcare bill. Several organizations including National council   of women organizations (NCWS), market Women Association, International federation of women lawyers, Health reform foundation of Nigeria (HERFON) among others stormed the National Assembly as shown in the photograph demanding for the immediate passage of the bill. Most of these people are acting out of ignorance and poverty of knowledge thinking the solution to their entire health care problems lies with the passage of the bill.

 This National health insurance scheme (NHIS) to me is an exercise in futility. It is like one of those elephant projects like the Ajaokuta Steel Mill that is usually embarked upon by our inept leaders only to be abandoned mid way when it had already gulped billions of Naira. The national health bill comes with a very attractive package but how can the country sustain its funding in this era of high economic recession. Expecting a workforce of 25% to cater for 75% of the population is unrealistic. Also mal-distribution of health facilities between urban and rural areas where 90% of disease burdens are in the rural areas which has only 10% of health facilities, increased maternal and child health care relative to spending. The signs of failure are already ominous. After almost 10 years of operation, it has only covered less than 5% of 150 million people despite the huge amount of money that has been sunk there. Hence, the NHIS is not the “messiah” we are waiting for that will take care of our health care needs. It is a complete socialist ideology that will not survive in a capitalist and highly corrupt country like Nigeria. It faces the stark reality of failure. Some of those pushing for the passage of the bill already know but selfish-interest and corruption has blinded them. Nigeria is the second largest exporter of oil yet most of her citizens live below $1 a day. Poverty and diseases abound. Basic amenities are completely lacking. Health improvement is inextricably linked to other environmental, social, cultural and economic factors. Availability of basic amenities of life is related to good health.

             I am totally in support of revamping Primary Health care (PHC) and increase its funding. Communities should be empowered to take care of their health problems. Community participation and ownership should be key to sustainability and self reliance in health development. Having practiced medicine in both rural and urban settings in Nigeria, I am very convinced that PHC still remains the cornerstone of health system development in Nigeria and the key to the attainment of Health for all Nigerians.



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  1. robertmartenjhsph Says:

    I find this post interesting. And while I perhaps don’t understand the intricacies of the Nigerian situation, I am not sure if PHC and the Nigerian NHIS need be inherently opposed to each other. Again I obviously don’t know all of the background, but from afar, I thought the bill seemed like a positive development. Sure it isn’t or wasn’t perfect, but it seemed like a step in the right direction. It was also celebrated in the Lancet ( It would be interesting to know more about this. Do you have any other resources that provide more details or commentaries on this bill?

  2. cheeseqo Says:

    I think the article is a bit to critical of the modest efforts by the Nigerian state to advance health-care financing. Health insurance isn’t just about who pays but also about generating funds to pay for the towering health costs of the country. My take is that it isn’t yet complete but definitely well conceived and a good first step. Let’s give the government and people of Nigeria a chance. Even the US has issues with it’s health system and insurance policies. No Law is perfect!!

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