The Nationwide Bureau of Statistics (NBS) stories that about 63%, or six out of each ten Nigerians, are multidimensionally poor, with well being shocks rating among the many prime 5 causes of impoverishment.
A 2023 World {Bank} survey titled “Welfare Impacts of Well being Shocks in Nigeria” discovered that households hit by sudden medical occasions had been thrice extra more likely to fall into poverty than these unaffected.
Again in Enugu, Chinyere, a 38-year-old lady, skilled a {financial} nightmare when her husband slumped whereas getting back from work final November.
He was rushed to the closest non-public hospital and identified with a stroke. The payments for checks, emergency care, physiotherapy, and drugs totaled over N2.5 million.
“The second he was wheeled into the emergency unit, the nurse requested for a deposit of N500,000. I needed to borrow it. Then got here the CT scan, medication, and physiotherapy classes. By the point we had been discharged, all our financial savings had been gone. My youngsters’s college charges had been unpaid,” she recounts.
On February 18, Akinbobola Folajinmi, a Lagos State resident, misplaced his spouse, Kemi, as a result of being pregnant problems. In video clips which have since gone viral, he defined how he took Kemi to a medical facility alongside the Lagos Lekki-Epe Expressway in Ibeju-Lekki. It was an emergency, however the hospital turned them away after he was unable to deposit N500,000.
“Sadly, they blindly rejected us and requested me to take her to the Basic Hospital at Epe, although the physician knew that Epe from Lakwe was approach too far for her situation. Earlier than we might rush her to Epe, she was gone,” Folajinmi says.
For a lot of, a single unexpected sickness or well being emergency can spiral right into a life-altering {financial} catastrophe—a phenomenon aptly dubbed the “well being invoice entice.” This entice springs from a confluence of things, together with insufficient healthcare infrastructure, the prevalence of out-of-pocket healthcare funds, households usually falling into poverty after a serious sickness or accident, and a big hole in medical insurance protection.
Nigeria’s healthcare system is considerably underfunded and underinsured. In line with the Nationwide Well being Accounts, out-of-pocket expenditure accounted for over 72% of whole well being spending in 2022, that means almost three-quarters of healthcare prices are borne instantly by people—lots of whom stay on lower than $2 per day.
These tales should not remoted incidents; they mirror the fact for thousands and thousands of Nigerians who lack sufficient medical insurance. Whereas the Nationwide Well being Insurance coverage Authority (NHIA) goals to offer common well being protection, its attain stays restricted.
Many Nigerians are unaware of the advantages of medical insurance, lack belief in insurance coverage suppliers, or have had dangerous experiences with the system, resulting in a excessive degree of mistrust.
With out insurance coverage, people are pressured to pay out-of-pocket for healthcare, making them susceptible to catastrophic bills. This reliance on direct funds creates a vicious cycle of poverty, the place a single medical disaster can erase years of hard-earned financial savings.
The “well being invoice entice” additionally impacts the healthcare system itself. Overburdened public hospitals, usually missing important assets, wrestle to offer sufficient care. Personal hospitals, whereas providing higher services, are sometimes prohibitively costly. This disparity creates a two-tiered system, the place entry to high quality healthcare is decided by socioeconomic standing.
“It was solely on the third hospital {that a} Good Samaritan, who had seen me in misery, supplied to assist. By then, I had misplaced quite a lot of blood,” she recounts.
A 2022 research by the Well being Sector Reform Coalition discovered that 41% of Nigerians delayed or averted hospital care as a result of {financial} constraints. This delay usually leads to worsened outcomes and better eventual prices. A standard coping technique for medical emergencies is promoting belongings, taking loans, or crowdfunding on social media, however these include their very own prices.
“The {economic} fallout from a single medical invoice may be generational,” notes Dr. Eze Victor, a well being economist on the College of Abuja. “The well being invoice entice is a posh difficulty that requires a concerted effort from the federal government, healthcare suppliers, and the neighborhood.”
In line with Dr. Victor, by addressing the foundation causes of this drawback, Nigeria can create a extra equitable and resilient healthcare system, the place entry to high quality care is just not decided by one’s {financial} standing. “Solely then can the nation really break away from the devastating cycle of poverty triggered by medical emergencies.”
Consultants consider that to forestall health-related poverty and the well being invoice entice, Nigeria should quickly scale up medical insurance protection, strengthen main healthcare, and enhance emergency medical companies.
“Common well being protection is just not a luxurious. It’s a necessity,” argues Dr. Larne Yusuf, a medical physician based mostly in Lagos. “We want obligatory community-based medical insurance, backed premiums for the poor, and a financing mannequin that swimming pools dangers.”
“There have to be political will,” says Dr. Yusuf. “Till healthcare is seen as a public good relatively than a personal burden, we’ll hold pushing individuals into poverty.”
“The nation has handed the Nationwide Well being Act, making medical insurance obligatory, however the uptake stays low. Why is that?” she requested.
“Insurance coverage is about paying prematurely for a service you would possibly want sooner or later. That requires belief—belief that the system will work if you want it, and that the care you’ll obtain shall be of excellent high quality. If individuals are requested to pay for insurance coverage however get turned away on the hospital or face poor therapy, the system breaks down.”
In line with Mrs. Ndili, the important thing lies in enhancing high quality throughout the board. “So, it’s actually about constructing belief in all the care expertise—belief within the infrastructure, within the personnel, and the processes. One with out the others results in inconsistent outcomes,” she stated.
