Chioma Umeha
With the poverty level of Nigerians which is put
at 70 per cent, reducing out-of-pocket payments for healthcare and making it
accessible to all, especially, the indigent at the grassroots has remained a
huge challenge to the country. However, health insurance provides financial
protection for the poor spreading risks and pooling funds makes healthcare
affordable and accessible to Oyo state indigenes, writes CHIOMA UMEHA.
To ensure universal access to quality health
delivery by protecting Nigerian families from financial barriers to health
care, and ensuring availability of funds to the health sector the National
Health Insurance Scheme (NHIS) was launched 14 years ago.
However, less than two decades after its launch,
experts have lamented on its slow implementation as only five per cent coverage
has been achieved by the scheme.
It is instructive to note that the NHIS was
established under Act 35 of 1999 by the Federal Government and is expected to improve access to health
services and bring overall development of the country
To ensure that residents in Oyo state enjoy the
NHIS, the state recently introduced a new premium payment for its insurance
scheme.
According to Dr Olusola Akande, the Executive
Secretary of the agency, Oyo State Health Insurance Agency(OYSHIA) farmers are
now allowed to pay premium with farm produce.
Speaking recently during a media visit facilitated
by United Nations Children’s Fund, (UNICEF) and Oyo State Health Insurance
Agency, Akande said;“Many people who would have loved to enroll in our health
insurance programme but lack the financial capacity to pay the premium
voluntarily agreed to give us yams and palm oil and other farm produce in lieu
of cash to be paid for the premium.” He further noted that even farmers and
others who cannot afford to pay the N8, 000 are encouraged to pay with their
farm produce to the agency in lieu of cash.
“In the agency, we have set up a marketing section
that is aiding us to sell the yams and palm oil and other farm produce and when
we sell them, we help the owners to keep the money until it is enough to pay
the premium and enroll them.”
Akande said the goal of health insurance was to
provide quality healthcare services for the people of the state without
experiencing catastrophic health expenditure.
He expressed worry that many people are still not
aware of the activities of OYSHIA and required the support of the media to
propagate the importance of health insurance to the people so that more people
would enroll.
“OYSHIA has been rated very high in terms of
performance. We will not relent in making sure that the people of the state
enjoy quality healthcare without expending their entire savings on medical bills,”
he stressed.
Akande, revealed that under two years, the scheme
has made amazing achievements which include over 80,000 enrollees from 33 LGAs,
350 vaginal deliveries and 78 caesarian sessions (CS), over 10,000 children
under five years and pregnant women covered, creating employment opportunities
for residents, upgrade of three fully upgraded OYSHIA accredited PHCs and seven
others at various stages of completion, as well as institutionalisation of
engagement platforms for various stakeholders.
Affirming that 100,000 civil servants had been
captured, but the target is 400 to 450,000. Akande regretted that in spite of
the success so far, there are still challenges such as beliefs, attitudes and
customs of people on insurance policies, adverse selection, attitude of
health-workers and enrollees, sponsorship and cross-subsidy for the vulnerable
groups and the poor, limited resources for advocacy, publicity and
enlightenment, and inadequate and untrained manpower logistics.
To him, it has become imperative for people to
visit their doctors as occasion demands with the aim of determining their
health status. According to him, health insurance remains protection against
financial hazards, spreading of risks and pooling of risk to ensure that people
remain healthy with a little financial resource.
Olufemi, Abimbola and Adebayo, who are also among
the 100,000 beneficiaries covered under the Oyo state health scheme, shared
their experiences during a media field trip to the Agbongbon Primary Health
Centre.
Olufemi, a teacher, like many other Oyo residents,
had prayed for stress-free access to healthcare even before he got married.
Like a dream come true, he was fortunate to be enrolled into the scheme a few
months after he got married. At first, he never believed that with just N8, 000
per annum, his wife could have a successful caesarean section without paying
through his nose.
“I registered about two months after I got married
and the first payment was made two months after. Luckily, my wife got pregnant
and gave birth and since then, I have been paying less to nothing. It may not
be 100 per cent success but I am happy with the programme.”
Also, five months old pregnant mother, Abimbola
Ahmed, could not help but express her joy. Ahmed says, “I paid only N2, 400 the
first time I came and since then, I have not paid any other money. I am happy
with the scheme. “You see many women in our community don’t have money but
since the government presented free delivery, many of us have been coming. You
can see that many people are here now. “I joined the scheme in March last year.
This programme is very good and beneficial because
they take care of us. They give pregnant women all the attention they need.
After your delivery, you would be given a bed for free”.
He also appreciated the UNICEF, for sponsoring and
financing the programme.
Another beneficiary, Mr. Adebayo, said that his
wife was on admission for two weeks after major surgery and was treated free,
without any charge.
“My wife did not pay a kobo in this place, all
tests and surgery were treated free. If they write drugs, I will go to the
pharmacy and they will give me free without any charge. When it was time for us
to be discharged, I was expecting to be given a bill but I did not get one. The
programme is really good and live saving”, he said.
Affirming the increase in the number of patients,
Assistant Record Attendant, Health Records at the Agbongbon PHC, Mrs. Adekola
Atinuke, made it known to DAILY INDEPENDENT that, every month, the Centre takes
40 deliveries a month and can be more sometimes.
“In the past, we used to have 20 to 22 deliveries
a month, but last month alone, we had 36 deliveries”, Atinuke said. “Last year,
we had 905 pregnant women in our record. But in the first five weeks of this
year alone, we have over 108 on the list already. “Although some women are
still going to Traditional Birth Attendants, TBAs, the introduction of OYSIA
has continued to increase antenatal uptake here and the number of other
patients at the Health Centre. More women are now delivering here since they
know they will not pay. At times, money can keep them away”.
Speaking, Fasan Desimola, a member of the medical
team said she has 600 enrollees in her care out of which government caters for
400 while the remaining 200 are private enrollees. “It has not been easy
getting people out to come and enjoy this programme, but it has given more
people the opportunity to access health care,” Desimola said. “I also have a
lot of pregnant women and children under five who registered free and they are
being catered for by the state government. “Also, many elderly ones are here.
It is easier for them to access health care here because their children can pay
from wherever they are. “I have a lot of hypertensive and diabetic patients. I
have never had any reason to complain. There is nothing more troubling than
when you manage a patient that cannot afford the cost of treatment, as a doctor
you cannot be happy.”
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