As Community Health Insurance Berths in Country

Nigeria's rural poor often wallow in ignorance, poverty and disease, which often decimate their population. Accessing quality healthcare have been a tall ambition for most of them as a result of the combined effects of poverty and lack of adequate health centres.

This sad situation, might be altered for the better if the novel community health insurance plan pioneered by Hygeia Nigeria Limited, a frontline health management organisation (HMO) in Lagos, is embraced by all.

For as little as N200 premium, an enrolee in Kwara State for instance, is qualified to enjoy free health services at designated hospitals for one full year. For market women in Lagos State, which is the second state for the pilot scheme, an enrolee is required to pay a premium of just N800 to enjoy free healthcare in quality hospitals distributed across the state for 12 calendar months.

This may sound incredible, but it is true, according to Mrs. Njide Ndili, managing director of Hygeia Community Health Plan, which is the company incorporated by Hygeia Nigeria Limited, the parent HMO, to execute the scheme. Speaking to THISDAY in her office last week, Ndili said the scheme has operated for a year in the two states with many more people taking advantage to improve their health condition. She said the health plan covers designated hospitals in both private and public health institutions for the beneficiaries.

"You discover that a lot of funds that we have in Nigeria targets specific diseases, but through the health insurance, we are targeting the whole person. So, when they go to the hospital and find out they are HIV positive in addition to something else, you treat the whole person. We had to make sure that there are certain ailments that are covered within the package", Ndili said.

Asked if the plan was all embracing, she said it covers the primary and secondary benefits of the National Health Insurance Scheme, adding; "It covers a little more than the NHIS. NHIS does not cover HIV/AIDS, but this package covers it".

Essentially, she said her company partners with PharmAccess International, a Dutch NGO and with the donor support of the Dutch Health Insurance to establish the scheme, which subsidises health insurance premiums for low and middle-income communities. The Dutch Health Insurance Fund (HIF), she added, is the first international fund of its type focusing on providing subsidies for community insurance schemes in Africa and it has selected Nigeria as the first country for implementation. She said the key overall objective of the HIF is to increase access to quality basic healthcare for currently uninsured groups, using a public-private partnership model. The grant for Nigeria is for a five-year period, in the first instance.

The first communities to benefit from the pilot scheme of the Hygeia Community Health Plan are some market women communities in Lagos State and the farming community around Shonga, Kwara State. "The HCHP offers access to good quality basic healthcare to individuals and families in these communities for subsidized premium rates ranging from N200 to N800 per person per year. This care is provided by designated private and public hospitals and clinics in areas near the targeted communities. Members of the communities are able to enjoy these low premiums because 90-95 per cent of the rates are paid for by the Dutch Health Insurance Fund", Ndili said.

According to the managing director, the medical care within this scheme provides a comprehensive healthcare package including outpatient care, specialist consultations, hospital admissions, drugs and pharmaceutical care, maternal care including ante-natal care and delivery, infant and child care including immunisations, minor & intermediate surgeries such as appendicetomy, herniotomy and cataract removal, HIV/AIDS treatment.

She said some Dutch companies operating in Nigeria also contributed part of the money, which is being used to operate the scheme. He said before the providers are enlisted into the scheme, they are made to undergo due diligence to ensure that they have the requisite personnel and facilities to provide the required care.

She commended the Kwara State government in this instance, for deploying a lot of resources to the public health centres for them to meet their stringent conditions. It was also as a result of the commitment of the state government to the scheme that about three communities are already enrolled in the community health plan.

The hospitals being used in Kwara State in the communities include, Shonga Main Primary Healthcare Centre, Bacita Health Care, Ogo-Oluwa Hospital and Alaafia Kwara Health Point being operated by the Kwara Wellbeing Foundation, the NGO run by Mrs Toyin Saraki, Kwara State first lady. The referral centres for the state include Sobi General Hospital, University of Ilorin Teaching Hospital and Ola-Olu Hospital, Ilorin.

The hospitals being used in Lagos are Surulere General Hospital, Agege General Hospital. R-Jolad Hospital, Bariga, Salvation Army, Lagos Island, Heals Specialist Hospital, Isolo and May Clinics, Ilasamaja. Others are Topaz Clinics, Surulere, Crystal Hospital, Akowonjo, Oshuntuyi Medical Centre, Agege and Lagoon Clinic, Victoria Island. The referral centres in Lagos are Lagoon Hospital, Apapa and Ikeja and the Lagos State University Teaching Hospital.