Table 1

A description of the Nigerian FSSHIP

PurchasersNHIS and HMOs. NHIS purchases tertiary services directly from state and federal tertiary care providers while primary and secondary care services are purchased through HMOs. They receive funds from the national government through the NHIS to purchase healthcare packages.
What services are purchased?Predetermined primary, secondary and tertiary care packages with some partial and total exclusions. Packages are same for all enrolees and are decided by the NHIS.
Who uses the services?Federal civil servants and organised private sector (formal private sector organisations with more than 10 employees). Coverage is only about 5% of the Nigerian population.
Who provides services?A mix of public, private and faith-based organisations.
How are providers paid?Primary care health services are reimbursed through capitation, secondary and tertiary care through fee-for-service (FFS). Public and private providers are reimbursed at the same rate.
  • FSSHIP, Formal Sector Social Health Insurance Programme; HMOs, health maintenance organisations; NHIS, national health insurance scheme.