By Olakunle Olafioye
The death of a pregnant woman in Lagos State after she was allegedly rejected by a private hospital owing to the inability of her husband to pay the deposit demanded by the hospital where she was rushed to recently has once again underscored the need for an effective and affordable health insurance package for Nigerians.
The woman, identified as Mrs Folajimi, reports claimed, died shortly after a private hospital refused to attend to her having been rushed to the facility from a birth attendant who attended to her earlier.
The private hospital, according to the deceased’s husband, reportedly demanded that a deposit of N500, 000 must be made before she could be attended to at the hospital.
The man who went live on social media as they were on their way to a general hospital in Epe from Lakowe when his wife gave up the ghost, blamed the hospital for the death of his beloved wife.
Accessing quality healthcare has become increasingly challenging for most Nigerians in recent years with the resultant effect being high mortality rate among average Nigerians as most people die from health concerns ranging from preventable to the mildest of health issues.
Public health commentators believe that universal health coverage can make a lot of difference in accessibility to healthcare, but lament the failure of the government to widen and extend the net of affordable health insurance coverage in the country.
According to the World Health Organisation (WHO), Nigeria has one of the highest maternal mortality rates globally, with a significant number of women dying during childbirth.
The global health body said Nigeria accounts for a substantial portion of global maternal deaths, with one in seven global maternal deaths occurring in the country.
A public health expert, Dr. Abdulaziz Shobo, said the high cost of healthcare in Nigeria is forcing many patients to turn to unapproved alternatives, skip life-saving medications or embrace counterfeit drugs.
He pointed out that the development has also pushed many citizens into poverty, particularly those with chronic illnesses.
Citing the example of the death of the Lagos pregnant woman, which he argued was avoidable, he said a viable and affordable health insurance scheme would probably have saved the life of the 31-year-old mother of two.
“The cost of healthcare in Nigeria, including consultations and treatments, is high, especially for private healthcare. Most Nigerians often die of treatable diseases on account of poverty and poor access to robust healthcare. This explains why Nigerians are desperately searching for alternatives, including the unsafe options,” he explained.
Speaking specifically on the death of the pregnant woman in Lagos, Shobo said it was regrettable that the incident happened in Lagos where, according to him, there is a working health insurance scheme. “Lagos State has a good health insurance package called Ilera Eko, which I consider relatively cheap and affordable considering the cost of accessing medical care in the country now.
“There are different packages depending on one’s financial capability. It is possible that the woman’s death would have been avoided if her family had subscribed to the scheme”, he opined.
The National Health Insurance Scheme (NHIS) in Nigeria, despite its critical role in aiming for universal health coverage, faces significant challenges.
Initiated in 2005 with the goal of universal healthcare access by 2015, the scheme has struggled with low enrolment rates, fluctuating numbers of healthcare professionals, and substantial out-of-pocket expenditures for citizens.
Current statistics indicate less than five per cent of Nigerians are enrolled in NHIS, while 70 per cent still finance their healthcare independently.
Major issues include inefficient service delivery, inadequate healthcare infrastructure, and poor resource management, leading to substandard care quality.
Recommendations for improvement focus on enhancing hospital efficiency, motivating and retaining healthcare workers, adopting appropriate technology, and clarifying prepayment mechanisms.
Findings by Sunday Sun indicate that factors such as inadequate awareness of the existence of such schemes in some states, ignorance and poverty are some of the reasons for the low enrollment level for insurance schemes.
The framework for the National Health Insurance Scheme requires that each state has its own State Social Health Insurance Scheme, SSHIA, to implement the scheme within its borders.
Apart from Lagos, findings show that only a few other states, which include Ogun, Ekiti, Rivers, Anambra, among others have relatively operational health insurance schemes. Unfortunately, however, only a few residents in these states are aware of the existence of such a scheme.
Sources at some of the government-owned hospitals in Lagos and Ogun states said over 90 per cent of patients who access healthcare services in the states pay from their pockets.
“Considering the fact that the majority of the patients who come here are those who pay directly for the services they access here shows that the interest or knowledge of the people in the state about Ilera Eko is still very low,” a source at the record unit of Orile Agege General Hospital, Lagos hinted.
A patient at the hospital who simply identified herself as Roseline said she was oblivious of the existence of Lagos State health insurance scheme.
“Sincerely, I am not aware that the scheme exists. And I am sure that most Lagosians are not aware of it. The government needs to do more by the way of adequate awareness campaign so that more and more people will get to know about the programme. If the government can invest the same level of efforts and energy they put in during electioneering to educate the people of the state about this scheme, more people will show interest in the scheme,” she said.
At the General Hospital Onipanu, Ota, Ogun State, some people who spoke to Sunday Sun said they were not aware that the state had any insurance scheme for the masses and called on the government to make affordable health a priority for the residents of the state.
One of them who identified himself as Lateef Idowu, said the government in Nigeria plays politics with the majority of their pronouncements.
“It is one thing to announce a plan or intention and it is another thing to back it up with action. If you look around; you can go to every section and do your survey. You will see that almost every patient in this hospital is paying from their pockets. Nobody is under any insurance coverage.