Technical support to NHIA to conduct baseline assessment of health insurance coverage in North-East, Nigeria

Description of the Project:

Access to affordable healthcare remains a significant challenge for most Nigerians, especially those in the informal sector. Despite the introduction of laws and policies like the National Health Act and the implementation of the Basic Health Care Provision Fund (BHCPF), coupled with the State Health Insurance Schemes, designed to improve access to essential health services for Nigerians, particularly the most vulnerable populations, health insurance coverage remains low, primarily due to the complex political, socioeconomic, and cultural barriers prevalent in the country. While the government has shown increased commitment to achieving universal health coverage (UHC), challenges such as poor coordination, limited capacity at state health insurance agencies, and unreliable data have hindered progress. The project, therefore, aims to address these challenges

The objectives of the project:

Aligned with Nigeria’s health sector renewal initiative, the proposed assessment aims to establish a baseline of current health insurance coverage to guide and monitor strategic interventions that will be used to progressively expand coverage and achieve the government’s set targets. The services of consulting firms are being sought to apply the comprehensive framework developed by technical experts to guide the assessment process. This framework outlines the critical factors needed for a thorough nationwide assessment of health insurance coverage. It integrates best practices, strategies, and quality assurance measures to ensure the accuracy and reliability of the assessment outcomes.

Specifically, the assessment will be conducted in the following thematic areas:

• Programmatic competencies: enrolment effectiveness, benefit packages, risk pools and strategic purchasing
• Operational competencies: data availability, performance management, reporting system, claims management and coordination, and
• Fiduciary competencies: fund flows, financial reporting, fund management and allocation and audit functions

Interventions/achievements: PGS will be conducting a rigorous and insightful baseline assessment of the health insurance landscape and provide a valuable understanding of the strengths, challenges, and opportunities therein. PGS will be leading the data collection; data analyses and Report Writing.

Related Activities: Project Management