Universal health coverage: An assessment of the national health Insurance scheme in a resource-limited environment

In 2005, the Nigerian government initiated a National Health Insurance Scheme (NHIS) with the goal of achieving universal coverage and financial risk protection for its entire citizenry. To achieve this goal, good performance needs to be demonstrated in the health financing functions of revenue collection, risk pooling and purchasing. This research study therefore set out to determine if the performance of the NHIS in these crucial functions so far can lead to the attainment of this goal. An analysis of secondary data was carried out using a framework developed by Carrin and James for assessing the performance of health financing systems in the crucial functions of revenue collection, risk pooling and purchasing. Preliminary findings show that the performance of the NHIS in the core functions of revenue collection, risk pooling and purchasing were significantly below the benchmark for well performing national health insurance schemes and was therefore unlikely to lead to the attainment of the desired goal of universal coverage if measures are not taken to improve performance in these core functions. Results and lessons learned that might be relevant to researchers, policy makers and administrators in the USA will be presented and discussed.