Achieving financial risk protection through a national Social Health Insurance Programme in Nigeria: Perspectives of enrollees and healthcare providers

2019 ◽  
Vol 35 (4) ◽  
pp. 859-866
Author(s):  
Gladys N. Ebunoha ◽  
Maduka D. Ughasoro ◽  
Ifeoma C. Nwakoby ◽  
Obinna E. Onwujekwe
Keyword(s):  
Health Insurance ◽  
Financial Risk ◽  
Healthcare Providers ◽  
Social Health Insurance ◽  
Social Health ◽  
Financial Risk Protection ◽  
Insurance Programme ◽  
Risk Protection ◽  
Health Insurance Programme

Healthcare System Challenges in Asia

2019 ◽  
Author(s):  
Winnie Yip
Keyword(s):  
Health Insurance ◽  
Health System ◽  
Financial Risk ◽  
Insurance Coverage ◽  
Social Health Insurance ◽  
The Philippines ◽  
Social Health ◽  
Equitable Access ◽  
Financial Risk Protection ◽  
Risk Protection

Important health system challenges in the east and southeast Asian countries/territories of Japan, South Korea, Taiwan, Hong Kong, Malaysia, China, Thailand, Vietnam, Indonesia, the Philippines, Laos, Myanmar, and Cambodia exist. The most commonly adopted health system among these areas is social health insurance. The high-income, aging societies of Japan, South Korea, and Taiwan have adopted single-payer/single-pipe systems with a single uniform benefit package and a single fee schedule for paying providers for services included in the benefit package. All three have achieved universal coverage with relatively equitable access to affordable care. All grapple with overutilization, aging populations, and hospital-centric and curative-focused care that is ill-suited for addressing an increasing chronic disease burden. Rising patient expectations and demand for expensive technologies contribute to rising costs. Korea also faces comparatively poorer financial risk protection. China, Thailand, Vietnam, Indonesia, and the Philippines have also adopted social health insurance, though not single-payer systems. China and Thailand have established noncontributory schemes, whereby the government heavily subsidizes poor and non-poor populations. General tax revenue is used to extend coverage to those outside formal-sector employment. Both countries use multiple, unintegrated schemes to cover their populations. Thailand has improved access to care and financial risk protection. While China has improved insurance coverage, financial risk protection gains have been limited due to low levels of service coverage, fee-for-service payment systems, poor gatekeeping, and the fee schedule that incentivizes overprescription of tests and medicine. Indonesia, Vietnam, and the Philippines use contributory schemes. Government revenue provides insurance coverage for the poor, near-poor, and selected vulnerable populations; the rest of the population must contribute to enroll. Therefore, expanding insurance coverage to the informal sector has been a significant challenge. Instead of social health insurance, Hong Kong and Malaysia have two-tiered health systems where the public sector is financed by general tax revenue and the private sector is financed primarily by out-of-pocket payments and limited private insurance. There is universal access to care; free or subsidized, good-quality public-sector services provide financial risk protection. However, Hong Kong and Malaysia have fragmented delivery systems, weak primary care, budgetary strains, and inequitable access to private care (which may offer shorter wait times and better perceived quality). Laos, Cambodia, and Myanmar’s health systems feature high out-of-pocket spending, low government investment in health, and reliance on external aid. User fees, low insurance coverage, unequal distribution of health services, and fragmented financing pose pressing challenges to achieving equitable access and adequate financial risk protection. These countries/territories are diverse in terms of demographics, epidemiological profiles, and stages of economic development, and thus they face different health system challenges and opportunities. This diversity also suggests that these nations/territories will utilize different types of health systems to achieve universal health coverage, whereby all people have equitable access to affordable, good-quality care with adequate financial risk protection.

scholarly journals Financial Risk Protection from Social Health Insurance

2016 ◽  
Author(s):  
Kayleigh Barnes ◽  
Arnab Mukherji ◽  
Patrick Mullen ◽  
Neeraj Sood
Keyword(s):  
Health Insurance ◽  
Financial Risk ◽  
Social Health Insurance ◽  
Social Health ◽  
Financial Risk Protection ◽  
Risk Protection

scholarly journals Financial risk protection from social health insurance

2017 ◽  
Vol 55 ◽  
pp. 14-29 ◽  
Author(s):  
Kayleigh Barnes ◽  
Arnab Mukherji ◽  
Patrick Mullen ◽  
Neeraj Sood
Keyword(s):  
Health Insurance ◽  
Financial Risk ◽  
Social Health Insurance ◽  
Social Health ◽  
Financial Risk Protection ◽  
Risk Protection

scholarly journals Critical Determinants of Demand for Services in the Nigeria Formal Sector Social Health Insurance Programme

2020 ◽  
Vol 5 (1) ◽  
pp. 1
Author(s):  
Obi Ikechukwu Vincent ◽  
Okoronkwo Ijeoma Lewechi ◽  
Iloh Gabriel Uche Pascal ◽  
Nwonwu Elizabeth Uzoamaka ◽  
Ogbu Kenneth ◽  
...  
Keyword(s):  
Health Insurance ◽  
Social Health Insurance ◽  
Social Health ◽  
Formal Sector ◽  
Insurance Programme ◽  
Health Insurance Programme

Utilization of tertiary institutions social health insurance programme (TISHIP) among undergraduate students in Enugu State

2019 ◽  
Vol 28 (4) ◽  
pp. 413
Author(s):  
CNdu Anne ◽  
CAniwada Elias ◽  
JOkoye Chinonso ◽  
COkoye Pamela ◽  
COkpala Anthony ◽  
...  
Keyword(s):  
Health Insurance ◽  
Undergraduate Students ◽  
Social Health Insurance ◽  
Social Health ◽  
Tertiary Institutions ◽  
Insurance Programme ◽  
Enugu State ◽  
Health Insurance Programme

scholarly journals Strategies to Improve Demand for Services in the Social Health Insurance Programme: Nigerian Enrollee Perspective

2020 ◽  
Vol 8 (1) ◽  
pp. 53
Author(s):  
Obi Vincent Ikechukwu ◽  
Ijeoma Lewechi Okoronkwo ◽  
Elizabeth Uzoamaka Nwonwu ◽  
Kamtoochukwu Maduneme Obi ◽  
Ifunanya Rosemary Obi
Keyword(s):  
Health Insurance ◽  
Focus Group ◽  
Moral Hazard ◽  
Social Health Insurance ◽  
Social Health ◽  
World Health ◽  
Identification System ◽  
The Social ◽  
Insurance Programme ◽  
Health Insurance Programme

Globally, the World Health Organization has championed the introduction of various forms of health insurance as a means of improving the utilization of quality healthcare service which is targeted at achieving universal health coverage. Unfortunately, the operations of the Social Health Insurance Programme (SHIP) have witnessed inefficiencies in the demand for healthcare services as a result of moral hazard and this is evidenced by the non-achievement of set-out objective of the programme in Nigeria. Design/Methodology: The study adopted a qualitative approach which comprised of 3 focus group discussions (N=24). Key informants were purposely selected for the focus group discussion from three (3) purposively selected hospitals, one from each categorized type of facility. Content analysis was adopted and further analysis was achieved with the aid of Nvivo 11 software, which coded and categorized nodes into themes. Results: The focus group participants relayed their experiences in the programme which includes poor identification system, choice of only one provider except on emergency, benefit package not being comprehensive which has enabled moral hazard and suggested ways to improve it. Conclusions: Most of the enrollees do not show diligence in areas of demand for services and these were shown to emanate principally from economic issues around the enrollees desire to utilize the premium paid thereby leading to moral abuse. Therefore, certain measures need to be put in place so as to curtail observed market failures in the SHIP programme.

scholarly journals The challenges of the Philippines' social health insurance programme in the era of Universal Health Coverage

2018 ◽  
Vol 8 (4) ◽  
pp. 175-180 ◽  
Author(s):  
A. Querri ◽  
A. Ohkado ◽  
L. Kawatsu ◽  
M. A. Remonte ◽  
A. Medina ◽  
...  
Keyword(s):  
Health Insurance ◽  
Universal Health Coverage ◽  
Social Health Insurance ◽  
The Philippines ◽  
Social Health ◽  
Health Coverage ◽  
Insurance Programme ◽  
Universal Health ◽  
Health Insurance Programme

scholarly journals Strategies to Improve the Supply of Services in the Nigerian Social Health Insurance Programme: Healthcare Provider Perspective

2019 ◽  
Vol 3 (4) ◽  
pp. 98
Author(s):  
Obi Ikechukwu Vincent ◽  
Okoronkwo Ijeoma Lewechi Okoronkwo Ijeoma Lewechi ◽  
Adi Jesse Ashumate ◽  
Iloh Gabriel Uche Paschal ◽  
Yakubu Adole Agada-Amade ◽  
...  
Keyword(s):  
Health Insurance ◽  
Healthcare Provider ◽  
Social Health Insurance ◽  
Social Health ◽  
Provider Perspective ◽  
Insurance Programme ◽  
Health Insurance Programme
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