Efforts towards universal health coverage gather momentum
•NBA, Garki Hospital partner on health insurance for lawyers
As part of efforts to ensure universal health coverage for all Nigerians by 2030 and prevent out-of-pocket payment for health services, the Nigeria Bar Association (NBA) has partnered the NNPC Health Management Organisation and Garki Hospital, Abuja.
The enviable step is enrolling a thousand lawyers in the National Health Insurance Scheme (NHIS). The package covers Group, Individual and Family Social Health Insurance Programme, GIFSHIP, in a pilot phase, which the NBA President, Mr. Olumide Akpata described as a game changer in caring for the well-being of lawyers and their families across the country.
The NHIS-GIFSHIP is a Health Insurance Scheme for lawyers conceptualised by the Olumide Akpata-led NBA Executive through the innovation and industry of the Welfare Committee chaired by Mr. Yakubu Maikyau, SAN.
At the inaugural ceremony in Abuja, last week, an elated Akpata described the event as epochal, signaling the beginning of other welfare packages for lawyers even as he recalled efforts in the past to provide insurance cover for lawyers.
“This has been a long journey for us. Today we official received the ID cards from the NHIS for our 1000 members who were enrolled into the pilot scheme. It is a shared moment because for me it signals the beginning of many good things.
“I personally encourage Nigerians to embrace health insurance because there is no way we can have adequate and quality health care by paying out of pocket.
Akpata disclosed that in 2014, the association entered into an MOU with Leadway Assurance to provide life insurance for lawyers. The package has proved unsustainable owing to the number of deaths and the huge cost of taking care of those injured in accidents.
He said while members were willing to support colleagues who fell sick, the cost of care for ailments as kidney dialysis and orthopedic surgery is astronomical. He cited the case of a lawyer who required N7 million for hip replacement. “Presently he cannot walk anymore; he cannot practice his profession. So we’ve been telling our members that you don’t need to wait until you find yourself in that situation. That is why we said let us enroll, let us look for the best and the most affordable health insurance provider”, he explained.
He praised his colleagues who did the spade work on the health insurance scheme, working with the NHIS to agree on a pilot phase, beginning with 1000 members across the country.
“I have been impressed with NHIS. The feedback has been great but it’s taken us this while. Even those who were given for free, getting them to register have been a challenge. So we say we will drag them, kicking and screaming, they will have to enroll. Because when anything happens, they will come back to us. Today we’ve received the cards, we tell them use the cards,” said Akpata.
The Medical Director at Garki Hospital, Dr. Adamu Onu was excited by the development. “This is truly an epochal event, because the truth is that we cannot take our healthcare to the next level without considering health financing and health financing cannot thrive by paying out of pocket. That does not meet the requirement of universal health coverage, which is our goal, and the only way we can achieve that is by expanding national health insurance for the whole community.
“Unfortunately over the years the coverage has not been as wide as it should be. So the fact that the NBA is coming on board is very significant. Their coming on board is to make it known to the public that yes this is a scheme that can work,” he noted.
Onu described health insurance as the future of healthcare in Nigeria. “I think people need to realize that if we want a health system like they have in UK, Canada and other developed countries, we need to have a well-developed health financing mechanism. Go to Europe and see how advanced their systems are, It’s not people paying money out of their pockets the way we do in Nigeria,” he argued.
He said Garki Hospital embraced the vision a long time ago as one of the few hospitals in this country running the health insurance scheme.
“Two-third of the patients that uses this hospital are on health insurance, so out of pocket patients are actually a minority and even the NHIS itself has acknowledge that and regard us as a model hospital for NHIS in the whole of this country. We have become so efficient that I dare say that we are probably the only hospital in this country that an NHIS or health insurance patient can see three specialists in one day. Here you can see the cardiologist, the neurologist and endocrinologist all in one day,” Dr. Onu told the NBA team.
Garki Hospital, Abuja (GHA) has grown and become a hospital of choice in the FCT and beyond since inception in 2007, it is a multi-specialty hospital, equipped with state-of-the-art facilities backed by a wide range of expertise and skilled personnel providing specialized and general care, in-patient and out-patient services. It has been a shining example of successful public-private partnership in health.
Executive Secretary NHIS, Prof. Mohammed Nasir Sambo, on a recent visit to the hospital, praised the PPP model operating at the hospital which he said has manifested in efficient management of human and material resources. He promised to partner with the hospital on its cost-effective method for delivering healthcare services.
Indeed, Onu used that opportunity to identify areas of improvement for Nigeria’s health insurance scheme as proper documentation of beneficiaries and their records as well as standardization to streamline areas of insurance coverage.
Garki Hospital, accredited by the NHIS in 2008, currently has one of the largest numbers of NHIS enrollees in the FCT and the only PPP that accepts secondary referrals from other facilities. The hospital is also the only facility that carries out specialized surgery under the NHIS scheme. The hospital has over 187,000 patients registered on Electronic Medical Record application, 33,906 NHIS enrollees spread across 55 Health Maintenance Organizations, HMO. Under the FCT Health Service Scheme, the hospital attends to 8139 enrollees from three HMOs, its Private Health Insurance Scheme has 1831 enrollees spread across 35 organizations and it offers corporate services to 10,502 persons from 16 registered organizations.
Onu said the scheme is working smoothly because the hospital ensures open and transparent billing system and ensures that no patient waits for more than 30 minutes before seeing a doctor.
The hospital has attended to closely over two million patients and encountered more than 40 open heart surgeries and 26 kidney transplants; no fewer than 100 hip and knee joint replacement surgeries; training in family medicine, O&G, pediatrics, anesthesia, & assisted reproductive technology and nursing services as well as in-vitro fertilization services.
It is a pioneer in the use of electronic medical record application on all facets of healthcare and has been operating a paperless service since 2016 Telemedicine services, the hospital is fully self-sustaining under the PPP arrangement and it has a continuous operation 24 hours a day. There are no strikes or interruptions in service.
The Federal Government recently announced its expansion of the health insurance system with the launch of a new health insurance package, Group Individual and Family Social Health Insurance Programme (GIFSHIP).
The Minister of Health, Dr. Osagie Ehanire, said the new insurance product is the outcome of wide-ranging and far-reaching reforms within NHIS to significantly increase the fiscal space for healthcare services.
He explained that the new product, expectedly, would address the challenges and barriers encountered during implementation of other insurance packages both by the beneficiaries and operators.
“It will also eliminate known difficulties, as it creates additional value by expanding and upgrading other insurance packages for better reach, service quality and user experience,” the Minister promised.
He said the major objective of GIFSHIP is to rapidly expand the scope of healthcare coverage in an urgent quest to attain Universal Health Coverage and leave no one behind.
He said: “GIFSHIP offers Nigerians opportunity to participate and benefit from the health insurance system. There’s opportunity for affordable individual enrolment, family unit or a group of people. Any of the enrolments can also be sponsored by well-meaning individuals, Trusts, or organizations.”
The Senate last year passed a Bill that will make health insurance mandatory for all Nigerians.