By Kayode Abdulazeez.
The initiative of Kwara State Government and Dutch Healthcare provider under Public Private Partnership (PPP) initiative is one major scheme worthy of emulation by other state governments.
The initiative launched by Dr. Abdulfatai Ahmed has been able to record some breakthroughs at taking healthcare delivery service to the people, even in the remotest part of the rural communities in the state. This was made possible through the partnership of Hygeia community health care, the Dutch health Insurance fund and Pharm Access. The partnership is aimed at providing access to affordable and quality healthcare to low income earners in rural areas and in the state generally.
Over the years, Nigeria had struggled to meet its people’s healthcare challenges. Although government has been working towards achieving universal healthcare since 2005 the health indicators are yet to improve.
A recent independent research revealed that Nigeria has 2 percent of the world’s population, with 14 percent of global maternal deaths. More than 12 percent of Nigerian children do not live to celebrate their fifth birthday, and 54 percent of Nigerians live in poverty, and the condition is worst in rural areas.
This and many other frontline based research works prompted Kwara State government to devise a partnership initiative with Dutch Health Insurance Fund, “Kwara State Community Health Insurance Scheme” (KWCHIS), to address the healthcare challenges facing the people.
Although, the programme started in 2007 under the regime of Dr. Abubakar Bukola Saraki , with few local governments.
Due to the remarkable success the programme recorded, It has created an enabling environment for the expansion of the scheme, operating in all three senatorial districts of the state. Hence, a Memorandum of Understanding (MOU)was signed in February 2013 by Dr. AbdulFatah Ahmed-led government.
The scheme attracted N500 pre paid charges for issuance of identity card that contains details of the subscriber before having access to the service which include primary healthcare, maternal care and treatment of chronic diseases such as tuberculosis, HIV/ AIDS and malaria.
Currently, the scheme has registered over 120,000 people. The Kwara government saw the need and has taken the lead in achieving affordable and comprehensive health care for its populace. This remarkable feat has distinguished the state of harmony as the first state in Nigeria to found a Public Private Partnership (PPP) to provide care for it is citizenry, with the state covering 60 percent of their health insurance premium.
The programme has also been able to reduce risk and increase trust in the health sector which leads to an upward spiral of higher quality health care , by the people willing to make pre paid payment for health insurance which leads to steady revenues for health care providers.
With increase in revenues, leveraged by the state and donor funding, local capacity and infrastructures for health care is being developed. Both public and private primary healthcare centres and hospitals are innovated in provisions of healthcare. Currently, the state government pays about 66 percent of the health insurance premium subsidy, in support of the programme . Investment has been made in administrative infrastructure to ensure transparency, accountability, efficient practices and quality control in the health system.
Another unique element of the health insurance scheme is the research component. Recently rigorous bio medical and socio economic impact evaluation are conducted by the university of Ilorin Teaching Hospital, Amsterdam Institute of Global Health and Development and Amsterdam Institute of International Development to continuously measure the impact of the programme and stimulate effective implementations. The Kwara Health Insurance Programme evaluation has shown that there is an increased health care utilization, reduced out of pocket payments and improved health outcomes among participants of the health insurance programme.
Research was also conducted into the cost effectiveness of maternal health care and the prevention of cardiovascular diseases as well as household financial diaries to understand how liquidity of solvability to enroll in health insurance or renew their membership. The KWCHIS research partnerships have resulted in significant research capacity building. The partnership clinics undergo a rigorous quality improvement assessment and upgrading the quality of care in the programme. More than 33 public and private clinics are taking part in the programme. The scheme provides an opportunity for experts from the private sector, academia, government and nongovernmental organizations and donors as well as local communities to discuss the research, lessons learned and their implication for capacity building and delivery of affordable quality health care in the state.
By 2017, the Kwara state will take full ownership of the scheme and intends to strengthen collaboration with donor funded programs and to further develop its insurance programme as a replicable model, serving as a blueprint for other states in Nigeria and abroad. Although some states like Ogun launched a health insurance programme based on the understudy of Kwara in 2014 and about 10 states have shown interest in replicating the Kwara model , including Lagos state , which has one of the highest population in Africa.
To make healthcare more accessible to people, the state government also embarked on comprehensive rehabilitation of five General Hospitals spread across the three senatorial districts in the state, which has been successfully completed and equipped with latest medical facilities and commissioned for use. A state of the art diagnostic centre was also established to boost diagnosis leading to prompt treatment and investigation of t specialized medical investigations. All these are priorities in order to make health care delivery accessible and affordable to the people.
