Administrative and Operational Challenges Facing Nigeria's National Health Insurance Scheme: A Stakeholder Survey in Lagos

This article examines stakeholder perceptions of the administrative and operational challenges associated with Nigeria’s National Health Insurance Scheme (NHIS) in selected establishments in Lagos State, Nigeria. The study adopted a descriptive survey design involving staff associated with the NHIS Council, Health Maintenance Organisations (HMOs), and health service providers (HSPs). The study population comprised 159 staff members, and 110 questionnaires were included in the descriptive analysis. The findings identified delays in remittances to HMOs and HSPs as the most frequently reported challenge, followed by inadequate healthcare facilities and personnel and concerns about the availability and participation of healthcare providers. Although most respondents believed the scheme had prospects for success, many considered its problems to be primarily administrative. The article discusses the implications of these findings for payment administration, healthcare service capacity, provider participation, and operational monitoring. The findings represent stakeholder perceptions in selected establishments in Lagos and should not be interpreted as a nationally representative assessment of Nigeria’s health insurance system.