New insurance scheme for poor

Thousands of low-income Nigerians will get access to inexpensive, basic healthcare as the new year begins under an ambitious five-year donor scheme aimed at improving health facilities in Nigeria.

The US $131 million Insurance Health Fund (IHF) was launched by the Dutch Ministry of Development Cooperation earlier this year and aims to provide collective health insurance to thousands of Africans working in the informal sector, such as farmers, market women and students.

Nigeria is the first African country where people can enroll, with basic health insurance offered to a group of female car mechanics in the commercial capital Lagos and a community of farmers in Kwara State.

Medical check-ups have already begun for the farmers, said Jan van Esch of Pharmaccess, the Dutch foundation overseeing the implementation of the scheme.

Most of the funding – US $33 million for five years – goes to the private insurer Hygeia, one of the largest commercial healthcare groups in Nigeria. Hygeia already provides health insurance to employees of large companies and multinationals such as Shell, and has contracts with a network of nearly 200 private and public hospitals.

Foreign aid for healthcare in Africa traditionally goes to government health ministries and hospitals, but economists argue that national healthcare systems won't improve unless the private sector, which is seen as more efficient, gets involved.

Pharmaccess hopes that the project will familiarise Nigerians with the concept of health insurance and boost the overall quality of healthcare, said Van Esch.

"What's new about this project is that it's demand-driven," he told IRIN.

"If a client is not satisfied with the care he receives, he can go to a different hospital."

If the project is successful and enough people enroll, the premium can gradually be raised to sustain the insurance scheme without donor subsidies, he said.

The insurance policy for the female mechanics in Lagos is 90 percent subsidised. Each woman pays a premium of US $6 per year for a primary healthcare package that includes treatment for HIV/AIDS, malaria and glaucoma - less than she usually spends on doctor's visits and medication.

For the group of farmers, the premium is even lower at $2 per year, with donor subsidies at 95 percent.

Once the project is up and running, the healthcare package can be adjusted to meet patients' demands, said Van Esch.

The Insurance Health Fund is the result of a meeting between Dutch multinational companies and government ministers to discuss a joint approach to fighting poverty in Africa.

The Dutch Ministry of Development Cooperation plans to roll out the IHF to at least three other African countries next year.

pb/cs