ILO's Social Protection Floor (SPF), the Employee’s Compensation Act (ECA) and the National Health Insurance Scheme (NHIS) Act : A Comparative Analysis
By
Femi Aborisade
Introduction
This paper is a
doctrinal and comparative paper in the sense that it sets out the basic
provisions of the ILO Social Protection Floor and attempts a comparison with
the National Health Insurance Scheme (NHIS) Act and the Employee’s Compensation
Act (ECA).
- Analysis
of key provisions of the ILO Social Protection Floor (SPF).
- Analysis
of key provisions of the NHIS Act
- General
Comparison of SPF with NHIS Act
- Relationship
between ECA and ILO’s SPF
- The
Role of Trade Unions
- Conclusion
ANALYSIS OF ILO’s SPF
Background to SPF
The Social
Protection Floor (SPF) was initiated by the International Labour Office and the
World Health Organization, involving 17 collaborating agencies, including the
United Nations (UN), NGOs and international financial institutions. The United
Nations System Chief Executives Board for Coordination (UNCEB) adopted the
Social Protection Floor Initiative in April 2009. In 2011, the International
Labour Organiation at its 100th Session adopted [certain]
‘Resolution and Conclusions concerning the recurrent discussion on social
protection’. The Conference, among other conclusions, acknowledged the ‘need
for a Recommendation complementing the existing standards that would provide
flexible but meaningful guidance to member States in building Social Protection
Floors within comprehensive social security systems tailored to national
circumstances and levels of development’. Consequently, on 30 May 2012, the
General Conference of the International Labour Organization, at its 101st
Session, adopted Recommendation 202 concerning National Floors of Social
Protection. This paper is based on the articulation of SPF as contained in the
ILO Recommendation 202.
The Goal of SPF
The
International Labour Conference at its 100th Session noted that the SPF
is not just a human right but that closing coverage gaps in social security
coverage is of highest priority for equitable economic growth, social cohesion
and Decent Work for all women and men
Thus, the ILO Recommendation 202, in its Preamble, declares social
security a right. The key goal of the SPF is to ‘prevent and reduce poverty, inequality, social exclusion and social
insecurity…’ Paragraph 2 of the Recommendation goes further to define SPF
as ‘nationally defined sets of basic
social security guarantees which secure protection aimed at preventing or
alleviating poverty, vulnerability and social exclusion’
The United
Nations Chief Executives Board (CEB) has also defined social protection floor
as an integrated set of social policies
designed to guarantee income security and access to social services for all,
paying particular attention to vulnerable groups, and protecting and empowering
people across the life cycle.
The central
target of SPF therefore is ‘support for
disadvantaged groups and people with special needs’ (Paragraph 16, ILO
Recommendation on SPF) through comprehensive national social security systems.
The Preamble
also makes it clear that the Social Protection Floor is based on the rights contained in earlier international instruments,
particularly:
- the
Universal Declaration of Human
Rights (UDHR) (in
particular, Articles 22 and 25),
- the
International Covenant on Economic,
Social and Cultural Rights (ICESCR)
(in particular, Articles 9, 11 and 12),
- ILO
social security standards, in particular the:
- Social
Security (Minimum Standards) Convention, 1952 (No.
102),
- the Income Security Recommendation, 1944 (No. 67), and
- the Medical Care Recommendation, 1944 (No. 69).
Who has primary responsibility for SPF?
Paragraph 3 of
the ILO Recommendation provides an answer to this question: it states that the
State has primary responsibility, as follows:
‘3. Recognizing the overall and primary
responsibility of the State in giving effect to this Recommendation.’
Minimum scope of SPF
Paragraph 5 (a)
to (d) of the ILO Recommendation on SPFs requires member countries to set a Social
Protection Floor that provides four (4) categories of minimum social security
guarantees:
- Provision
of Health care (on a universal basis), which includes maternity care, that meets the criteria of availability,
accessibility, acceptability and quality;
- Income
security for children, which guarantees access to nutrition,
education, care and any other necessary goods and services;
- National
Minimum income security for persons in active age who are unable
to earn sufficient income in cases of:
- sickness
(sick benefits);
- Unemployment
(unemployment benefits)
- Maternity
(maternity benefits)
- Disability
(Disability benefits), and
- National
Minimum income security for
older persons (old age pensions,
regardless of prior employment status or sector of employment, if
previously employed)
Paragraph 9(2)
complements paragraph 5 by providing that:
‘(2) Benefits may include child and
family benefits, sickness and health-care benefits, maternity benefits,
disability benefits, old-age benefits, survivors’ benefits, unemployment
benefits and employment guarantees, and employment injury benefits as well as
any other social benefits in cash or in kind.
Schemes
Paragraph 9(3)
identifies the Schemes that may be established to provide the benefits. They
include:
- universal
benefit schemes,
- social
insurance schemes,
- social
assistance schemes,
- negative
income tax schemes,
- public
employment schemes, and
- employment
support schemes’
Minimum Coverage of SPF
Paragraph 6 of
the Recommendation provides for universal
coverage, stating that ‘Members should provide the basic social security
guarantees referred to in this Recommendation to at least all residents and children’
Sources of funding benefits
In line with
Paragraph 3, which places primary responsibility on the State to implement the
SPF, paragraph 12 also provides that national social protection floors should
be financed by:
- national
resources, and
- International
support, where national capacity is inadequate
Paragraphs 10
and 11 identify ways to facilitate mobilization of resources for SPF
nationally:
- Contributory
schemes, individually or collectively, taking into account the
contributory capacities of different population groups. (Paragraph 11)
- enforcement
of tax obligations (Paragraph 11)
- reprioritizing
expenditure (Paragraph 11)
- broadening
national revenue base (Paragraph 11)
- Implementing
measures to prevent fraud, tax evasion and non-payment of contributions.
- promoting
productive economic activity and
formal employment through policies such as:
- government credit
provisions (paragraph 10)
- labour inspection
(paragraph 10)
- tax incentives (paragraph
10) and
- policies
that promote:
- education (paragraph 10)
- vocational training
(paragraph 10)
- productive skills and
employability (paragraph 10).
Guiding Principles[2]
The ILO
Recommendation on SPF prescribes the following principles to guide the
implementation of the programme:
Member nations
are required to apply the following principles:
(a) universality of protection, based on
social solidarity;
(b) entitlement
to benefits prescribed by national law;
(c) adequacy and predictability of
benefits;
(d) non-discrimination, gender equality and
responsiveness to special needs;
(e) social
inclusion, including of persons in the
informal economy;
(f) respect for
the rights and dignity of people covered by the social security guarantees;
(g) progressive realization, including by
setting targets and time frames;
(h) solidarity
in financing while seeking to achieve an optimal balance between the
responsibilities and interests among those who finance and benefit from social
security schemes;
(i) consideration of diversity of methods and
approaches, including of financing mechanisms and delivery systems;
(j) transparent,
accountable and sound financial management and administration;
(k) financial,
fiscal and economic sustainability with due regard to social justice and
equity;
(l) coherence
with social, economic and employment policies;
(m) coherence
across institutions responsible for delivery of social protection;
(n) high-quality public services that enhance
the delivery of social security systems;
(o) efficiency
and accessibility of complaint and appeal procedures;
(p) regular
monitoring of implementation, and periodic evaluation;
(q) full respect for collective bargaining and
freedom of association for all workers; and
(r) tripartite participation with
representative organizations of employers and workers, as well as
consultation with other relevant and representative organizations of persons
concerned.
(paragraph 3).
Establishment of Legal framework
The ILO requires
that the basic social security guarantees should be established by law (paragraph
7) based on national consultations through effective social dialogue and social
participation (paragraph 13).
ANALYSIS OF THE NATIONAL HEALTH
INSURANCE SCHEME (NHIS) ACT
Establishment
The NHIS was
established by the National Health Insurance Scheme Act, 1999 but it fomally
took off in 2005.
Key Objective
The Long Title
to the Act states that the key objective is to ‘[ensure] access to good health
care services to every Nigerian and
protecting Nigerian families from financial hardship of huge medical bills…’.
The Condition for entitlement to healthcare services
Payment of rates
of contribution as may be prescribed[3]
from time to time by the Scheme’s Governing Council is the condition for
accessing health services provided by the Scheme (see sections 16 and 17, NHIS
Act). In other words, beneficiaries under the Scheme must have the financial ability to pay the prescribed rate of
contribution. The poor who lack the financial capacity are thus clearly
excluded. This is in spite of the fact that the NHIS is funded by grants from
the Federal, State and Local Governments, as well as international or donor
agencies (S. 11, NHIS Act).
Categories of Contributors
The NHIS Act
provides for two categories of contributors (Ss. 16 and 17):
- employee
contributor, and
- voluntary
contributor.
An employer
(whether in the private or public sector) ‘who has a minimum of ten employees’
(S. 16(1), is required to apply to register itself and its employees with the
Scheme. The employer is empowered to deduct the contribution by the registered
employees from their salaries and pay both its contribution and the employees’
contribution into the account of designated Health Maintenance Organizations
(S. 17(1) and (2).
The ‘voluntary
contributor’ is a person other than an employee who opts to register with the
Scheme and pays the prescribed rate of contribution (S. 17(3).
FUNDAMENTAL WEAKNESSES OF THE NHIS
- ACCESS TO
HEALTH SERVICES IS BASED ON ABILITY TO PAY; NOT BASED ON HEALTH AS A RIGHT
Considering the
fact that access to health services under the NHIS is based on ability to pay
the prescribed rate of contribution, and not on account of need for health
services, it can be concluded that the NHIS is not founded on the recognition
that access to health is a right. The ability
to pay as a condition to be entitled to healthcare services is therefore an exclusionary
policy. Employees working for an employer with less than ten employees are
excluded, employees who do not earn enough as to be able to afford registering
with the Scheme are excluded, the unemployed, poor farmers, the informal
sector, children and the aged are equally excluded. From findings by
journalists, the NHIS currently covers only between 4m and 5m contributors.
This means that the Scheme covers only about 3% and excludes the remaining 97%
of the population, based on 170million estimated population of Nigeria.
The exclusionary
policy contained in the NHIS Act is contrary to the provisions of the ILO
Recommendation on SPF and other international instruments, including the
African Charter. The African Charter, just as the ICESCR and the UDHR, earlier
referred to, provides in Article 16 that:
Article 16(1):
Every individual
shall have the right to enjoy the best attainable state of physical and mental
health.
Article 16(2):
State parties to the Charter are:
to take the
necessary measures to protect the health of their people and to ensure that
they receive medical attention when they are sick.
That
overwhelming majority of Nigerians are excluded from the NHIS is shown by
findings by newspaper journalists who variously established that since the
Scheme officially took off in September 2005, only between 4 and 5m[4]
contributors/beneficiaries have subscribed. So, almost all Nigerians, or around
170million people and at least 93% of the population are excluded from the
NHIS.
- NHIS IS SET
UP TO PROVIDE LIMITED AND DEFINED RANGE OF HEALTH SERVICES
The scope of health services provided to
contributors by the NHIS is too limited. The NHIS is not set up to provide
comprehensive health care based on the health condition of the contributors.
For example, as Section 18 shows, ‘health care providers’ are to provide:
·
‘defined elements of curative care’ (S.
18(a);
·
‘prescribed drugs and diagonistic tests
(S. 18(b), meaning they are to provide predetermined range of drugs and tests;
·
‘maternity
care for up to four live births for
every insured person’ (S. 18(c), meaning children born after the fourth child
are not entitled to health care services under the Act;
·
‘consultation
with defined range of specialists’
(S. 18(e);
·
‘eye
examination and care, excluding test and
the actual provision of spectacles (S. 18(g); and
·
‘a
range of prosthesis and dental care as
defined’ (S. 18(h).
The defined and limited range of health care
services provided under the NHIS run
contrary to Article 12 of the International Covenant on Economic, Social and
Cultural Rights (ICESCR, 1966), which provides that:
1. The
States parties to the present Covenant recognize the right of everyone to the
enjoyment of the highest attainable standard of physical and mental health.
2. The
steps to be taken by the States parties to achieve the full realization of this
right shall include those necessary for:
(a) The provision for the reduction of
the still birth rate and of infant mortality and for the healthy development of
the child;
(b) The
improvement of all aspects of environmental and industrial hygiene;
(c) The prevention, treatment and
control of epidemic, endemic, occupational and other diseases;
(d) The creation of conditions which
would assure to all medical services and medical attention in the event of
sickness.
- NHIS AS A
SOURCE OF WASTE AND AVOIDABLE EXPENDITURE
The NHIS has a
Governing Council, other full time Staff, national headquarters, zonal offices,
zonal officers, registered Health Maintenance Organizations (HMOs), registered Health
Care Providers, and so on[5].
The central purpose of the NHIS structure is geared towards enlisting ‘health
care providers’ (that is, government and private health care practitioners, hospitals
or maternity centres) to provide health services to insured persons or
contributors. The Governing Council and the army of its full staff are not
recognized to enter into contracts with health care providers. Contracting with
health care providers for the purpose of rendering health care services under
the Act is assigned to Health Maintenance Organizations (HMOs) (S. 20(e).
The Health
Maintenance Organizations (HMO) is defined as an organization ‘registered by
the Governing Council to utilize its administration to provide health care
services’ through approved health care centres (S. 49). Among others, a health
maintenance organization collects contributions from ‘eligible contributors’,
pays capitation fees for services rendered by health care providers (S. 20),
and invest and mange the funds accruing to it from contributions received
pursuant to the Act (S. 19(2).
It is my contention
that the NHIS structure and modus
operandi constitute a drain on public resources. It is similar to what
operates in the US where the health system
consists of largely private hospitals and other health facilities funded by
private health insurance. However, the US system provides state insurance
(medicare and mediaid) for the poor and elderly. On the basis of
reliance on private hospitals (which the Nigerian NHIS Act calls ‘health care
providers’), the US has the most
expensive health care system in the world. But its health outcomes, for
example, life expectancy and child mortality rates are almost the lowest of the
developed countries. Large numbers of Americans (nearly 20% of the population)
are not insured and have to pay their own fees if they fall ill.
The NHIS could
exist as a unit of the Ministry of Health and staffed by public employees to carry out administrative functions,
within a context where the State/government takes primary responsibility for
health care, as a right. Even in the UK, the
principle that health services should be available to all at the point of
delivery is accepted across the political spectrum. The new leader of the Conservatives
has recently said that they now accept that principle.
The capacity of
public hospitals should be enhanced to render health services rather than
relying primarily on private health care providers. In this way, more doctors
and other medical staff would be required and employed. In that context, the
NHIS would not require a Governing Council whose Chairman is appointed from the
private sector (S. 2(3), NHIS Act) and earning salaries and allowances that
could employ several health personnel. Contracting Health Maintenance
Organisations to contract with health care providers would also be absolutely
unnecessary. But the NHIS, as currently structured, is programmed to attain the
neoliberal policy of the State passing responsibility for health care
provisioning to the private sector. That is why one of the listed objectives of
the NHIS is to ‘improve and harness private sector participation in the
provision of health care services’ (S. 5(g), NHIS Act).
- NHIS ACT
DOES NOT REFLECT THE GUIDING PRINCIPLES CONTAINED IN THE ILO SPF
Based on the
three identified weaknesses above, it can be deduced that the NHIS Act is not governed
by the guiding principles contained in the ILO’s SPF, which is itself based on
existing international instruments.
It is clear from
the foregoing that the following guiding principles stipulated in Paragraph 3
of the ILO Recommendation 202, are not observed in the NHIS Act:
- universality of
protection (Paragraph 3(a);
- adequacy
and predictability of benefits (Paragraph 3(c);
- social
inclusion, including of persons in
the informal economy (Paragraph 3(e);
- tripartite
participation with representative organizations of employers and workers (Paragraph
3(r) – at least, it formally excludes representation of the TUC in the
Governing Council.
RELATIONSHIP BETWEEN EMPLOYEE’S COMPENSATION ACT
(ECA) 2010 AND ILO’S SPF
The Employee’s
Compensation Act, ECA, 2010 can be related to ILO’s SPF to the extent that it
may be presumed to represent an attempt to fulfill the right to health as far
as industrial injuries are concerned. However, it is necessary to bear in mind
that ECA is relevant only to compensations for any death, injury, disease or
disability arising out of or in the
course of employment.
By virtue of S. 26(1) of ECA,
In addition to
the other compensation provided by this Act, the Board may provide for the
injured employee any medical, surgical, hospital, nursing and other care or
treatment, transport, medicines, crutches and apparatus, including artificial
members, that it may consider reasonably necessary at the time of the injury
and thereafter during the disability, to cure and relieve from the effects of
the injury or alleviate those effects…
As indicated above, apart from healthcare and
disability support, the ECA, in its Part IV (sections 17 to 30) recognises the
following three broad categories or five specific categories of incapacity:
1. Fatal
cases – death, resulting from injury or disease
2. Permanent
Disability
a. Permanent
total disability
b. Permanent
partial disability or disfigurement
3. Temporary
Disability
a. Temporary
total disability
b. Temporary
partial disability
What is considered to be of particular relevance
here is to determine whether the rates of compensation are adequate to ensure
the standard of health as perceived in international instruments.
We may measure
adequacy of compensation based on the categories of scale of compensation
stated above:
1. Fatal cases, i. e. Death –
2. Permanent Total Disability –
3. Permanent Partial disability -
4. Temporary Total Disability -
5. Temporary Partial Disability -
In order to have
a sense of the inadequacy or otherwise of the compensation rates under the Act,
let us assume a deceased or injured worker on the minimum wage of N18,000 per
month, for each of the above five categories of disability.
Measuring Adequacy of Compensation in the Event of
Death of the Injured Employee (S. 19 and S. 17(1)(a)(i) subject to S. 17(1)(c)
as regards a child-dependant)
The compensation
payable here varies between 90 and 30
per cent of deceased employee’s earnings, for the lifetime of the beneficiary, depending
on the number and composition of the dependants. For an employee on the minimum
wage, this translates to between N16,
200 and N5, 400. The adequacy or inadequacy of compensation in this
category can be imagined.
It should be
noted that the dependants are denied the benefit of likely increased wages of
the employee based on improvement in performance, increased number of years of
practical experience, promotion based on training and educational development,
and so on.
Also, whereas
children are dependent on their parents, even after their studies until they
secure gainful jobs, S. 17(1)(c) of the
Act provides that ‘monthly payments to eligible children under this Act
shall be made to children up to the age of 21 or until they complete
undergraduate studies, whichever comes first’. In this era of widespread
unemployment where what is certain is the unlikelihood of securing jobs after
undergraduate studies, S. 17 (1) (c) of the Act is a harsh provision, which
deprives children of deceased employees of compensation.
Measuring Adequacy of Compensation Based on
Permanent Total Disability (Ss. 21(1) and 23), ECA).
The statutory
provision under this subhead is periodic
payment of 90 per cent of the employee’s earnings, until he attains 55 years of
age, or if he is already 55 or more, then, for 2 years after the date of the
injury.
Thus a 54-year old employee on N18, 000 per month
will earn 90% of N18,000 or N16,200 per month for only one year for a ‘total
disability’ that is ‘permanent’.
Measuring Adequacy of Compensation Based on
Permanent Partial Disability (S. 22(2), ECA)
For a disability
that is considered to be Permanent Partial Disability, the compensation is periodic payment of 90 per cent of an estimate of the loss of remuneration,
which results from the disability or impairment, until the employee attains 55 years of age, or if he is already 55
or more, then, for 2 years after the date of the injury. For the employee on
the minimum wage scale, for whom the estimate of the loss of remuneration is considered to be 50%, his compensation will be
90% of N9,000, which gives a take home pay of N8,100 per month for one year,
until he attains 55 years of age.
In the case of Temporary Disability, whether Total (S.
24(1), ECA) or Partial (S. 25(1),
which lasts for not more than 12 months, only a Lump sum payment (that is, a
once and for all payment) based on the degree of disability in accordance
with the Second Schedule to the Act will be paid. Thus, in the case of loss of
limb or Loss of both hands or of all fingers and thumbs for which the Second
Schedule to the Act provides for 100% degree of disability, the maximum lump
sum compensation, which an employee on the National Minimum Wage is entitled to
is N18,000.
The big question
is: are these rates of compensation for
industrial hazards adequate to maintain health as defined by WHO and UDHR? The
evidence provided above suggests that this is clearly not the case. The
Employee’s Compensation Act, 2010 does not provide for adequate compensation in
line with international standards and norms, which the Government of Nigeria
has signed up to.
THE ROLE OF TRADE UNIONS
The trade unions
have a responsibility to accept and campaign nationally for it to become a
societal norm that the State has primary
obligation to:
- Accept
that health care is a fundamental right which is supplied free to all
citizens when it is needed.
- Accept
primary responsibility for health services to all its citizens.
- The
basic issue which NHIS raises is: who should pay the cost of health care?
Should health care be accessed only by those who can afford to pay or
should governments provide for all, particularly the poor?
- The fact
that all economies are subject to economic booms and recessions is a
strong reason why government should be made responsible for health care. In
recession, unemployment increases
as well as diseases of poverty and stress. Thus, many people need health services most when they can least afford
to pay for them or when they are no longer insured through their work.
- :
- Health
care services should be paid for
from general taxation, rather than relying on health insurance
schemes.
- There
tends to be much less direct
control of health expenditure where health insurance schemes are used,
which explains why countries such as the US and France have so much
trouble controlling their health costs. For example, the US spends more
on administering its health insurance system per person than the total
health-spend per person in all but the most developed 35 countries.
- Also,
health insurance emphasizes curing
of illness rather than prevention, whereas prevention is much more
efficient especially in Africa where diseases such as malaria, diarrhea,
HIV/AIDS etc could be avoided much more cheaply than the cost of their
treatment.
- Assume
primary responsibility for implementing ILO’s SPF without shifting responsibility
to the private sector. The private sector should contribute through
general corporation tax. Schemes other than the system by which the State
accepts primary responsibility for health care to all the citizens have
proved to be inefficient and costly to administer.
- Amend
the NHIS Act, particularly to remove all provisions, which make it
exclusionary. The effect of the exclusionary character of the NHIS is that
when families belonging to the excluded 93% of the population fall sick,
they have to beg, steal or borrow to access health care. The result is
unnecessary death, disease, pain and suffering. Concerns and worries from
attempting to repay the debt incurred in accessing health care could also
result in long term poverty and other stress-related health conditions.
- Ratify
and implement, as indicated in Paragraph 18 of the ILO Recommendation 202,
the Social Security (Minimum Standards) Convention, 1952 (No. 102), other
ILO social security Conventions and Recommendations setting out more
advanced standards, as well as other relevant UN instruments, such as the
ICESCR.
- Accept
and campaign that the right to
health is not just the absence of diseases or infirmity but a state of
complete physical, mental and social wellbeing (Preamble to the
Constitution of the World Health Organization, WHO).
For the
avoidance of any doubt, Article 25(1) of the Universal Declaration of Human
Rights (UDHR, 1948) has expatiated and clarified WHO’s definition of the right
to health:
- Everyone
has the right to a standard of living adequate for the health and
well-being of himself and his family, including food, clothing, housing
and medical care and necessary social services, and the right to security
in the event of unemployment, sickness, disability, widowhood, old age or
other lack of livelihood in circumstances beyond his control
The understanding in both the WHO definition of
health and Article 25(1) of the UDHR places a responsibility on civil society,
including the trade union movement, to demand that governments should implement
other socio-economic rights as part and parcel of the right to life (guaranteed
under S. 33 of the 1999 Constitution) and the right to health, which the NHIS
purportedly sets out to fulfill.
CONCLUSION
We live in an age which is characterized
by many successful attempts to hijack the State from serving the interests of
the poor and marginalized to serving only the interests of the wealthy, exploiters
and looters of the public patrimony. The age when UDHR was declared is
gradually giving way to the age when aggressive efforts are being made to take
away these rights, not only at national levels but also at international
levels. Advocacy for those rights and
the primary role of the State to implement socio-economic rights should be
combined with practical protests, rallies and strikes for their full
realization.
Every human right has a relationship to
the right to life. To that extent, every right should be:
o
Universal,
o
Inalienable,
o
Equal,
o
Indivisible,
o
Interdependent and
o
Interrelated’.
Similarly, under international human
rights law, membership of the United Nations is accompanied by certain obligations on
the part of the ratifying State. Every State has the obligation to respect,
protect, and fulfill human rights. The obligation to respect means that the
state must not interfere with the enjoyment of given rights; the obligation to
protect implies that the State restrains third parties who may infringe on the
rights of others while the obligation to fulfill means that the state takes
positive measures to promote enjoyment of rights. These obligations of the
state under international law would not be observed unless the working masses
take practical action to protect and advance their rights.
The Nigerian labour movement
should learn from its South African counterpart where civil organizations are
formed by trade unions to carry out massive protests for provision of housing,
against forceful eviction, lack of access to water and electricity, including
active campaigns against disconnection of non-payers.
REFERENCES
Statutes
Cited
Employee’s Compensation Act, 2010
National Health Insurance Scheme Act,
1999.
Websites
http://www.ilo.org/dyn/normlex/en/f?p=1000:12100:0::NO::P12100_INSTRUMENT_ID:3065524
(R202 - Social Protection Floors Recommendation, 2012 (No. 202)
http://www.ilo.org/global/publications/ilo-bookstore/order-online/books/WCMS_146616/lang--en/index.htm
(Extending social security to all – A guide through challenges and
options)
http://www.ilo.org/public/english/protection/secsoc/downloads/bachelet.pdf
(Social protection floor for a fair and inclusive globalization)
http://www.ilo.org/public/english/protection/secsoc/downloads/bachelet.pdf
(UNICEF-ILO Social Protection Floor (SPF)
Costing Tool Explanatory Note)
[1]Being paper delivered at a
Workshop organized by the Food, Beverage and Tobacco Senior Staff Association
in collaboration with Friedrich Ebert Foundation on the theme
"Social Protection and the Decent Work Agenda in the Food. Beverage
and Tobacco Industry: Issues Arising" on 19th-
20th April, 2013 at Grand Inn and Suites, IJebu-Ode, Ogun State
[2] In this subsection, the
statements in bold formats from ‘a-r’ are author’s addition.
[3] In reality, the
employer pays 10 per cent of the employees’ basic salary while the employee
contributes five per cent of his/her basic salary. A policy usually covers a couple
and four children under the age of 18 (http://nationalmirroronline.net/new/health-insurance-scheme-still-in-a-shambles/).
[4] http://www.tribune.com.ng/index.php/features/31498-national-health-insurance-scheme-of-what-benefit-to-nigerian-masses,
http://nationalmirroronline.net/new/health-insurance-scheme-still-in-a-shambles/,
www.ncbi.nlm.nih.gov/pubmed/23064174,
http://jointlearningnetwork.org/content/national-health-insurance-system
[5] Currently,
findings by journalists reveal that 61 Health Maintenance Organisations (HMOs)
have been accredited and registered by NHIS in addition to about 6,000 primary
care providers, 1,000 ancillary providers, and over 600 secondary and tertiary
providers (See notation number 2 above).
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