Health insurance reaches cocoa and gold mining families in Nigeria

ABUJA, Nigeria (ILO News): For many workers in cocoa-growing and artisanal gold-mining communities in Nigeria, adequate healthcare is expensive and hard to access. The ILO, through the ACCEL Africa project funded by the Government of the Netherlands, is supporting enrolment campaigns to change this reality.

More than 5,000 people have already participated in these campaigns, and Abdulkareem Salau is one of them “The health insurance card may look like just a card,” he says, “but for me, it represents hope, access, confidence and the opportunity to receive proper healthcare without the costs I experienced before.”

“The health insurance card may look like just a card ... but for me, it represents hope, access, confidence and the opportunity to receive proper healthcare without the costs I experienced before.” Salau, beneficiary.

The aim is to protect families against the cost of illness, one of the triggers of child labour. Most households in these communities work in the informal economy, with irregular incomes and no health cover. When someone falls ill, they pay out of pocket or go without care, and children are often sent to work on farms or mining sites to make up the loss.

© ILO / Celine

© ILO / Celine

Mr Abdulkareem’s experience is common in Nigeria’s cocoa-growing and artisanal gold mining communities. Most families work in the informal economy, with irregular incomes and no health cover. When illness strikes, they pay out of pocket, delay treatment or turn to unregulated remedies.

These health shocks have a direct link to child labour. When a household must suddenly find money for a hospital bill, children are often the ones sent to work on farms or mining sites to make up the gap. Protecting families against the cost of illness removes one of the triggers that pushes children out of school and into work.

How the campaign works

The ILO brings together the state health insurance agencies, the State Operations Coordinating Units (SOCU), the National Identity Management Commission (NIMC) and local partners to deliver, in a single visit:

• awareness sessions on health insurance and how to use it;
• on-the-spot enrolment and insurance cards;
• registration or update in the State Social Register, which opens access to other government support;
• issuance or verification of National Identification Numbers (NIN).

What changes for families

Once enrolled, families use their card at the primary health centre in their community for consultations, tests, medicines and treatment.

For Basirat Oyewole, 45, also from Aponmu, the change is real. “There were times when I had to go to the farm to pluck leaves and prepare (medicinal) herbs because I did not have money to buy medicine,” she says.

Now she goes to the community health centre for medical services. When the project team visited, a nurse was checking her blood pressure. “We don’t have to delay seeking medical attention just because we are afraid of the cost” the nourse said.

In Wasimi Odunwo, another cocoa community in Ondo State, Adebayo Wosilat is an elderly grandmother who can no longer work. She cares for her grandson, Omotayo Toheeb, who is enrolled in an ACCEL Africa skills training programme as an alternative to hazardous work. With her insurance card, she was examined, given medicines and had blood tests at Molete Igbara Hospital, all at no cost.

“Today I was well attended to, and my grandson now has the chance to learn a trade too... the health insurance has taken a burden off my shoulders.” Adebayo Wosilat, beneficiary.

Enrolment continues in cocoa and artisanal gold mining communities. The ILO is working with state agencies to turn the campaign into a step-by-step model that states can run and scale on their own or with support of the private sector, particularly cacao and gold-mining companies.

The ACCEL Africa project, funded by the Government of the Netherlands, supports governments and social partners to tackle the root causes of child labour in cocoa, coffee, cotton, tea and gold supply chains in Africa.