COMMUNITY BASED HEALTH INSURANCE PROGRAMMES IN NIGERIA: BORROWING A LEAF FROM THE FUNCTION ALIGBO (UDI) COMMUNITY SOCIAL INSURANCE SYSTEMS.

Community Based Health Insurance (CBHI) is a form of local mutual aid scheme built on the concept of social solidarity, mutual trust, and social welfare. In Nigeria, it is an arm of the informal sector of the National Health Insurance Scheme. The purpose of this commentary is to make a strong case for strengthening the functions of CBHI schemes in Nigeria using an example of an existing local community social insurance system. This is with the hope that strengthening CBHI schemes will increase coverage of the informal sector of the national health insurance programme, which represents the majority of the Nigerian populace.

In this commentary, two mutual support practices among men in the Umukwu kindred of Udi town in Enugu State, Nigeria were described, as well as the extent to which these practices help protect members from unforeseen expenditure and the sharing of financial burden where applicable. This is achieved through certain statutory contributions given to a financial member in times of need, and was likened to the financial risk-sharing mechanism of a health insurance system. It was also made clear that financial support from such contributions is usually not sufficient but can go a long way in meeting the financial demands of specific aspects of an expenditure.

References were made to the Rwandan model, where CBHI (mutuelles de santé) has helped provide up to 90% health coverage in the country and is internationally recognized for attaining universal health coverage.

Conclusion: This commentary has shown that existing local mutual aid practices can provide the baseline needed to strengthen CBHI functions in order to extend the reach of health coverage through the nation’s wide informal sector of the economy and bridge the coverage divide between the formal and informal sectors.