Health is an important determinant of economic development; a healthy population means higher productivity and higher income per head. Human health, as an essential part of any societal economic activity, also assumes a prominent position on the Maslow hierarchical ladder of human needs. Thus, without good health conditions, an economy loses its ability to develop competitive productivity, which possibly hinders economic growth. In general, when global health conditions are disrupted by a pandemic, a severe global economic crisis may emerge, as has been witnessed by the COVID-19 pandemic since 2020 – a situation that will potentially continue in the years ahead according to the World Bank, 2021.
Meanwhile, it is no longer news that health insurance is an important mechanism to prevent financial hardship in the process of accessing healthcare services. What is of great concern is the fact that since the launch of Nigeria’s National Health Insurance Scheme (NHIS) in 2005, only 59% of Nigerians have health insurance and 70% still finance their healthcare through Out-Of-Pocket (OOP) expenditure!
Furthermore, apart from the public distrust of health maintenance organizations (HMOs), there is equally distrust between HMOs and healthcare providers on the other hand. Sadly, som e these firms are known to always fall short in their obligations to healthcare providers. This, needless saying, has contributed to weakening public trust in them the more, thereby eroding confidence in the National Health Insurance Scheme, as a whole.
However, despite these myriad of challenges which include the rapidly growing population, coverage to only one sector of the population, lack of awareness of the scheme, distrust, shortage of human resources, and lack of funds to implement the scheme, there are a number of highly dependable, reliable, credible, honest, and financially-capable HMOs who are consistently fulfilling their obligations to healthcare providers and enrollees.
To In this Special Independence Anniversary Edition, The Guardian showcases three of such integrity-driven HMOs in Nigeria, viz: Defence Health HMO, Songhai Health Trust and ProHealth HMO Ltd,
DEFENCE HMO LTD: Providing Effective, Comprehensive Free Healthcare Delivery For The Nigerian Armed Forces, Their Families
The welfare of military servicemen and servicewomen is always a matter of priority in all nations of the world. This is on account of the nature of their job, which entails sacrificial service, every so often, requiring paying the supreme sacrifice in the defence of their countries. With this realisation, adequate attention is given to the provision of necessary amenities to the military personnel, most notably, comprehensive healthcare. The Nigerian Armed Forces is not an exception and has always made adequate provisions for the healthcare of her personnel, from enlistment to retirement and beyond.
With the institution of health insurance in Nigeria vide Decree 35 of 1999 (later Act 35), and the actual commencement of the Scheme in 2005, the Military were among the first beneficiaries being an organized body that could be easily brought onboard the Scheme. The then NHIS (now NHIA) elected to operate through the instrumentality of HMOs, accordingly, DHML was established in 2005 by the Federal Ministry of Defence and the Nigerian Armed Forces specifically, to function as the HMO for the serving and retired personnel of the Nigerian Armed Forces, and their families.
The Vision of DHML is “To become a leader in the healthcare maintenance organization business and act as benchmark for the country”, while its Mission is “To promote an efficient, effective and comprehensive free healthcare delivery to the officers and men of the armed forces of Nigeria and their families.”
DHML was incorporated by the Corporate Affairs Commission (CAC) on 21 October 2005 and accredited by the National Health Insurance Scheme with HMO code number 022 on 27 June 2006. Operations commenced shortly after accreditation from a modest headquarters at a rented facility in the Wuse, Zone 2 Area of Abuja, from where the headquarters was relocated in July 2011 to a permanent, purpose built facility in the current location at Apo, Gudu District of Abuja.
Over the years, DHML has grown in all ramifications and currently operates about 200 military and about 2000 civilian Primary Healthcare Providers. Also, DHML is affiliated with about 157 secondary/tertiary Health Care Providers, 33 of which are military medical facilities. The remaining 124 secondary/tertiary Health Care Providers are civilian medical facilities spread across the country.
Under the capable watch of AB Afolayan, GSS, Psc, FWACP, MBBS, FCAI, a Surgeon Rear Admiral (Rtd) as the Managing Director and Chief Executive Officer, DHML has a Board which is headed by the Honourable Minister of Defence and has the various Service chiefs as members with the MD/CEO as the Secretary. The Board approves the budget as well as major policy decisions of DHML. Additionally, there is aTechnical Committee for DHML, which has the MD/CEO as the Chairman and the professional heads of the medical services in the various Armed Services as members. The Technical Committee advices the Board on the technical medical and allied medical issues.
DHML has been a resounding success story with the health insurance administration in the military widely adjudged as one of the best in the country. This is the official position of the NHIA, the regulatory body for health insurance in the country.
SONGHAI HEALTH TRUST: Raising The Bar Of Excellence, Strengthening Nigeria’s Health Insurance Industry Through Innovative Products/Services
Songhai Health Trust Limited is one of the first generation and leading Health Maintenance Organisationss (HMOs) in Nigeria that has continued to raise the bar of excellence in the health insurance industry in the country. The is solely due to the company’s rebranding effort has delivered great value for us and our enrollees especially in the areas of customer experience and value enhancement for all our stakeholders. The company’s healthcare plans cover promotive, preventive and curative healthcare services and are specially designed to the pay of individuals and families.
With the Vision “To become the most efficient, reliable and affordable managed healthcare service provider in Nigeria”, the company’s Mission is well cut out “To provide a personalized healthcare experience, through cost effective solutions, seamless technology and transparent engagement with all stakeholders”
According to the Managing Director and Chief Executive Officer of the company, Bello Bawa Bwari, Songhai Health Trust Limited’s goal is “To ensure that quality healthcare services that meet international standards are made available, accessible and affordable, and delivered ethically to our clients, through a network of accredited healthcare providers across the country.
In his words, “We take pride in being driven by ethics in the provision of managed healthcare services to public and private sector employers/employees, as well as our teeming population in the informal sector. Our services are provided under a prepaid arrangement, in partnership with our selected healthcare providers spread across the country. Our products are designed with due consideration to the varied needs and ability to the pay of the different population groups in the country.”
Bwari maintained that “We take quality assurance very seriously and have implemented comprehensive sets of measures to ensure the excellence of our services. These measures include stringent provider selection, continuous monitoring, feedback mechanisms and adherence to best practices.”
He noted that “the NHIA Act will have a huge impact on the development of healthcare throughout the country particularly, reducing the volume of out-of-pocket expenditure for all Nigerians. Although the healthcare sector is riddled with a lot of challenges, the present efforts by the government towards standardizing regulations and operations will begin to bear fruits soon. The new NHIA Act will impact positively across the value chain.”
He stressed that “As one of the frontline health maintenance organizations (HMO), Songhai Health believes a few additional modification will go a long way in achieving an enhanced coverage to vulnerable Nigerians. Some of these suggestions include the harmonization of a credible national social investment registers, Improved funding for public health facilities, improved training for community healthcare workers and coordination of all healthcare administration under a single national framework.
As the healthcare industry is projected to grow significantly in the next five years, we can leverage on given opportunities to expand our services, partnerships, growth in market shares global presence, and strengthen our competitive advantage.”
PROHEALTH HMO LIMITED: Providing Excellent Service Delivery Through Dynamic Multi-Skilled Work Force
ProHealth HMO Limited is a duly registered company and accredited by the National Health Insurance Authority (NHIA) (code-057), as a national Health Maintenance Organisation (HMO) to provide social and private managed care Health insurance service for institutions, corporate organizations, groups, families and individuals.
ProHealth HMO is a Public-Private driven enterprise established by the Nigeria Social Insurance Trust Fund (NSITF) with investment contribution from private individuals and organizations. The NSITF established the company as a special purpose vehicle (SPV) to meet its strategic objectives and plans in realizing its statutory mandate under the ILO convention No 102 of 1952 (Minimum Standards fulfilment of the Medicare requirement) of providing Social Security Insurance as it relates to health.
Since incorporation in June, 2008, PHL has lived up to its vision which is “To be a world class Health Maintenance Organization (HMO) that facilitates quality and affordable health care services in Nigeria and beyond”. With paid up share capital of over N1billion and over 1500 partner Providers, ProHealth has competed favourably with both pioneers and its peers, in spite of a total lack of allocated federal lives.
According to Mr. Chinedu Nnabuihe, Managing Director of ProHealrh HMO Ltd, “As a National HMO, ProHealth has carved a niche for itself in State’s health insurance schemes and Community based Health Insurance Programs (CBSHIP). We are currently in partnership with many states across the federation in the implementation of their states’ health insurance Schemes and our track record of excellent service delivery has been recognised through various awards.
ProHealth has a dynamic multi-skilled work force comprising of professionals in the health sector, business analysts, financial experts, legal and information systems specialists. In ProHealth, we believe in adhering to the highest standards of professional practice and ethics. Our success is driven by our people and their unrelenting pursuit of excellence and focus on delivering results. We operate on high tech ICT infrastructure support system which adds value to service delivery and synchronization of all zonal activities.
Our Board comprised of seasoned technocrats headed by Professor Gabriel O. C. Okenwa, OFR, and have been pulled from the public and private sectors to guarantee the right mix of capabilities and skills required to meet the performance of an ambitious Health Insurance Industry. Our directors are experts in their respective fields and have brought a wide range of business, financial and global perspectives to the Board through active participation in governance and strategic planning of the Company.”
