Monday 29 September 2014

Nigeria: Ushering Community Based Health Insurance Scheme in Akwa Ibom


Who Was in Uyo — Recently, the Essien Udim Local Government Area of Akwa Ibom State was in joyous mood as they witnessed the launching of the Community Based Health Insurance (CBHI) programme, the first CBHI to be launched in the Akwa Ibom State.
The primary health care facility at Ikoh Ide village in Ukana West Ward II, where the launching took place wore a new look. Dance groups dominated by women including masquerades were on ground. Visitors and indigents were treated to the peak by the dance groups.
The NHIS headquarters had earlier requested the Akwa Ibom state government to identify three local government areas in the state for support in the introduction of the pilot scheme following which Essien Udim was selected.
Speaking at the event, Akwa Ibom State Governor, Godswill Okpabio said: "At the beginning of our administration, we declared free health care for our children under the age of five years, pregnant women and elderly.
"Today, as we launch this CBSHI in our state, we have thrown open the door to make health care accessible to every person in our society. This scheme, we believe will relieve people of financial burdens in the process of seeking medical care, thus eliminating a major challenge which deprives people from accessing medical care.
"It should be noted that the out of pocket payment at the point care has over the years restrained access to medical care. The implementation of this CBSHI will help to resolve this challenge.
"My administration has in the last seven and a half years invested enormously in the health sector in order to increase accessibility to qualitative medical care and qualitative health care delivery."
He continued that: "I invite all of us to share our hope and faith that this event will further our days in the health sector and remain a mile stone in our uncommon transformation of the health care in our state.
"This faith and hope is anchored on our solitude that we are obliged by a social contract which exist between the government and the governed to ensure no person dies before his or her time and that we provide the best Cosmo health facility, conditions and specialists to meet the health care needs of our people.
"It is upon such a venture that we are gathered today for this community based social health insurance scheme. We believe that our antecedents will provide eloquent testimonies to our unrelenting commitment to ensure that our people get qualitative health care services."
Represented by the Commissioner for Health, Dr. Emem Bassey, the governor recalled that the progress towards the pilot programme of the CBHI began in 2011 with a number of structures and frameworks and that collaboration and technical assistance have been provided since inception by the Management Science for Health (MSH) which remains the key technical partner support to the state on CBHI and brings demonstrable experience and expertise from implementing CBHI across Africa, South America, South East Asia.
He said specific interventions have taken place to facilitate the successful take off. One of such is a learning tour facilitated and financed by MSH PLAN health was conducted to existing CBHI programmes in Lagos; presentations on the Kwara programmes were also made available for knowledge sharing.
Launching the scheme, the Minister of Health, Onyebuchi Chukwu noted that the programme was a collaborative effort of the Akwa Ibom State Government, the MSH and the National Health Insurance Scheme, stressing that, "we decided to walk along this platform to actually showcase the benefits of health insurance at the rural level."
Represented by the Executive Secretary of the NHIS, Femi Thomas, the Minister said: "This scheme has been given a Presidential mandate of universal health coverage by 2015, that was in 2005, but I am sure it is clear to everybody that we are far from there. The coverage as it is today is still around single digit percentage; which is not something that we want to celebrate.
"So, there is this renewed mandate by Mr President that the scheme should actually cover at least 30 percent of the population by the end of 2015. And, then, this renewed effort to mobilize all Nigerians in their different locations and sectors to key into one health insurance programme or the other, so that we can achieve Mr President's mandate.
"In order to achieve this mandate, we have designed many programmes to cater for various socio-economic groups in the country. We have similarly developed operational guidelines spelling out the mechanism, accreditation procedures and requirements and quality assurance processes among others.
"Within nine year of official flag-off, the NHIS has covered the proportion of the population that still stands at a digit percentage as I mentioned earlier. This is largely made up of 98 percent of federal government employees.
"Similarly, over 1.6 million pregnant women and children under-five are being covered under the NHIS MDGs/Maternal and Child project in 14 states of the federation presently. Additional states are being engaged for this programme.
"The tertiary health insurance programme which has the potential to cover three million lives is also being repackaged. As at today, we have been able to cover 900,000 of this three million population. This spreads across 113 institutions in the country. The voluntary contribution programme of the scheme, along with various health plans of the organized private sector have been providing cover for those in the sector with their respective families.
"The other programme at the verge of being rolled out include cover for public primary schools in the country. This is a programme that will start as soon as the students resume school in first time of 2014/2015 session. The target population is about 24 million lives; and we know that Akwa Ibom will play its own role to ensure effective coverage for pupils in public primary school in the state."
He also announced that "our Mobile Health Insurance programme is on course and that the pilot work of the programme started in Lagos State. This is the first of its kind in the world.
"There are other programmes that are being developed right now; we have programme for the corps members. We have also been developing programme for political appointees, families of Nigerians in the diaspora, prisons inmates, indigent and retirees.
" Nigeria has very large informal sector and, therefore, it is clear to us that we can't achieve Mr President's mandate without delving into the informal sector. Therefore, the community-based health insurance remains a veritable tool for ensuring wider coverage, improved ownership, renewed culture of health insurance in Nigeria.
"The scheme is willing and ready to invest money and other resources to develop community-based health insurance all over the country.
"We have gone round the geo-political zones of Nigeria and we have done a full analysis of the factors that will facilitate sustainable health insurance in Nigeria. At this juncture, we are going to urge all state governments in Nigeria to embrace health insurance as the way forward; limit intervention programmes that are not sustainable and invest in health insurance which remains the only tool that is tested and acceptable worldwide in health care financing.
"The approach adopted by NHIS in the implementation of community-based health insurance took cognizance of community ownership, social solidarity inherent in the Nigerian people and cultures and the various socio-economic groupings in the country.
"The NHIS will subsidize the community-based health insurance programme for pregnant women and children under-five for the duration of the pilot.
"The scheme is working assiduously to cover the vulnerable group in the society. These are those who do not have the financial capability to contribute to the prepayment plans of the scheme. The creation of vulnerable group fund will certainly be the solution to providing cover for those groups; and that we have done."

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