A LEGAL SURVEY OF HEALTH INSURANCE IN NIGERIA AND SOUTH AFRICA: PROSPECTS, CHALLENGES AND WAY FORWARD

Abstract

Health insurance plays a vital role in improving access to quality healthcare and protecting households from the financial burden of medical expenses. The study does not only examine health insurance in South Africa and Nigeria, it also highlights the key prospects of health insurance in both countries and provides a comprehensive understanding of the structural and systemic barriers that hinder the effective administration and implementation of health insurance in the countries. The study adopted both doctrinal and empirical research, drawing on materials from the internet, library, case laws, articles, and journals. It highlights that despite the establishment of the National Health Insurance Scheme (NHIS) in 1999 and its operational launch in 2005, Nigeria continues to face low health insurance penetration. A very large number of people, particularly in rural and less-developed areas, remain uninsured, leading to forgone medical care and financial hardship. Key challenges identified include a lack of public awareness, low enrollment rates, and operational inefficiencies. The research also identified political and institutional challenges, such as the vertical and horizontal fragmentation of authority that limits top-down accountability for health service delivery. Based on these findings, the study concluded with specific recommendations that includes; to strengthen the system, including streamlining the registration process, improving service quality, and increasing government funding to ultimately achieve Universal Health Coverage.