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‘Mandatory health insurance will ensure universal coverage’

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Dr. Ben Nkechika

*Delta’s contributory programme covers 112,169 registered enrollees with N7,000 premium
As part of efforts to ensure cheap, accessible, qualitative and out-of-pocket medical services as well as achieve universal health coverage (UHC), the Delta State Government has rolled out a massive contributory but mandatory health insurance programme.

The programme is a deviation from the ailing National Health Insurance Scheme (NHIS), which is optional.

With just N7,000 premium, the Delta State Contributory Health Scheme (DSCHS) is already providing pre-paid health services to 112,169 registered enrollees, according to Interswitch Smartinsure Database, and free to pregnant women and children under the age of five.

The DSCHS was established by the Delta State Contributory Health Commission (DSCHC) Bill, which was signed into law by the Governor of Delta State, Dr. Ifeanyi Okowa, on February 4, 2016.

Director General and Chief Executive of DSCHC, Dr. Ben Nkechika, told journalists that a premium of N7,000 only was adopted after consideration and review of the Actuary analysis report with focus on the affordability of the average family to ensure no one is left behind.

Nkechika said that the scheme has commenced service in 63 secondary healthcare facilities, to pregnant women and children under five years with the transition of the free maternal and child Health programme to the state health insurance scheme.

Nkechika said a total of 24,725 pregnant women and 39,142 Children under five years (a total of 63,867) have been registered and receiving free treatment at these facilities budgeted and paid for by the state government.

He said 97 Primary Healthcare Centers (PHCs) spread across the state have been considered appropriate to commence provision of service under the scheme in August 2017 and a quality of service improvement programme has been initiated to achieve 100 PHCs before the end of October 2017 through partnerships especially in healthcare service disadvantaged areas.

The Bill to establish the DSCHS was transmitted to the Delta State House of Assembly on the 22nd June 2015. The Bill went through a first reading on the June 24, 2015, second reading on the August 12, 2015 as well as a public hearing on the August 26, 2015. The Bill had its third reading and was passed into law by the Delta State House of Assembly on the December 9, 2015.

Nkechika said the Law establishes DSCHC, DSCHS and other matters connected thereto as well as a Governing Board for the Commission, which will regulate, supervise, implement and ensure effective administration of a mandatory DSCHS for all residents of Delta State.

The physician said the public-sector workers in the formal sector group have signed up to be included in the scheme with the commencement of the deduction of 1.75 per cent of their consolidated salary while the government will contribute an equivalent 1.75 per cent on their behalf. 49,000 public sector workers have been enrolled into the scheme.

He said 16 associations in the informal sector group have signed up to be included into the scheme with the commencement of their enrolment and payment of premium to the commission.

Nkechika said the Delta State Government has conducted a Baseline Assessment survey that determined: key household demography and health seeking behavior of Deltans to guide planning for expanded health insurance coverage; determined the current household spending on health, health insurance coverage needs and willingness to pay for health insurance in Delta State; the proportion of Delta State residents in the lowest socio-economic quintiles, to guide decisions on subsidy and or exemptions from payment; the availability and capacity of health delivery facilities in Delta State to deliver proposed health insurance services; and the readiness of health facilities to deliver proposed services across all 25 Local Government Areas (LGAs).

Nkechika said the government has appointed and inaugurated the Board with a Chairman of the Board and the Director General/Secretary of the Board of the DSCHC.

He said through the DSCHC, the state has established an operational office at No 10 DBS Road Asaba; developed a website for the Commission www.dschc.org.ng; engaged and trained 45 personnel deployed from the State Civil Service system to work in the various departments of the Commission; commenced a Statewide health service quality improvement initiative with visit to healthcare facilities across the state and production of a data base of public healthcare facilities in Delta State; and conducted advocacy meetings with the Hospital Management Board, Primary Healthcare Development Agency, Private Healthcare Providers Association, LGA chairmen, LGA PHC coordinators, various formal and informal sector associations and other relevant stakeholders.

Nkechika said the DSCHC representing the Delta State Government has signed an Memorandum of Understanding (MOU) with Servier Pharmaceutical of France for its “Hospital Cash Cover Programme” that will provide subsidized antihypertensive and diabetics drugs; train 200 medical service delivery personnel in Delta State on the latest treatment protocol in management of hypertension and diabetes; support the Delta State government through payment of premium for an agreed number of vulnerable people under the scheme and eventually produce generic drugs for use under the scheme from Servier/SWIPHA manufacturing facility in Nigeria.

He said the commission has commenced the Strategic Implementation Plan (SIP) to deploy the ICT platform of the scheme using Interswitch software and infrastructure, with the signing of a contract with Interswitch to provide an elaborate online real-time electronic payment systems as well as an identity and health insurance management solutions that will ensure payment of premium for the scheme through several options that include Quickteller, POS, ATM, Cash at bank, and Webpay. Interswitch service will also include provider payment services, analysis and reporting.

To enhance diversity in registration options, Nkechika said the commission has commenced deployment of customized desktop computers that will be solar powered to 165 healthcare facilities. This system, he said, will provide Electronic Medical Record (EMR) services and registration option for the vulnerable group members and will also have a treatment protocol software that will assist nurses and Community Health Extension Workers (CHEWs) at the PHCs in their service capability and a seamless referral system between the PHCs and the Secondary facilities.

Nkechika said the commission has incorporated the MTN Y’ello Doctor Mobile Medical Intervention Scheme to enhance access to healthcare service in the most rural communities. He said the MTN Mobile Clinic would be deployed to rural communities currently disadvantaged in terms of access to healthcare services.

To enhance sustainability of the scheme, Nkechika said, various organizations have been contacted to solicit their support for the Scheme. “SHELL has written to offer technical support to the Scheme. Chevron has visited the Commission and offered to support the Scheme. Nigerian Petroleum Development Company (NPDC) has requested for an addendum to the GMOU with their host communities as a platform for their support. The commission is well positioned to receive and collaborate with donor organizations for their support to the commission,” he said.

Meanwhile, the scheme was, earlier in the year, awarded the 2017 Outstanding Healthcare Programme of the Year. The award was presented at the Nigerian Healthcare Excellence Award ceremony in recognition of the States outstanding service delivery in the field of healthcare in Nigeria and the state supported health insurance scheme.


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