Health Insurance: Pathway to attain Universal Health Coverage
In this report, our South-West Bureau Chief, HAMEED OYEGBADE writes on how the health insurance scheme in Oyo State creates a pathway that could lead to the attainment of universal health coverage in the state.
The popular saying, “a stitch in time saves nine”, could best describe the case of a woman that stormed the office of the Oyo State Health Insurance Agency (OYSHIA) to enrol her sick child for health insurance. She was well attended to and the registration was successful. But this woman could not use the plan immediately as she wanted because it has not yet matured. The Executive Secretary of OYSHIA, Dr Olusola Akande who narrated the story of the woman said she could have enrolled her child earlier instead of waiting until the baby was sick.
Akande said “When that woman came and enrolled her child. She wanted to start using the plan immediately because the baby was already sick before she enrolled her. Meanwhile, it doesn’t work that way. After the enrolment, it will take a little time before the beneficiary could begin to enjoy the health insurance facility. That’s why it’s good to take appropriate action at the right time,” Dr Akande said.
Mrs Atinuke Ajibola
In the case of Mrs Atinuke Ajibola, a resident of Agbongbon in Ibadan, Oyo state, she was full of praises to God that his son, Abiola Ajibola survived an illness that almost killed him. The joy of Atinuke was not just that her son didn’t die, she was also happy that she could get medical treatment for the boy at the right time without the burden of out of pocket payment. She expressed joy that she did not become bankrupt because of the sickness of the boy.
“I heard about the health insurance scheme and I registered my son with the Oyo State Health Insurance Agency (OYSHIA). When he was sick, I didn't hesitate to take him to the hospital and he was treated. If not for the health insurance, I wouldn’t have the courage to go to the hospital because I don’t have money”.
For Dr Akande, people like Ajibola have joined hands with the state government for the attainment of the Universal Health Coverage (UHC) while majority of residents of the state are yet to come on board. Dr Akande said only 100,000 enrolled for the health insurance programme out of 8,351,831 people in the state. He said there are 1,670,366 children that are below five years of age in the state and that there are only 10,000 children less than 5 years on the scheme.
From this indication, large numbers of people in Oyo state are too far away from health coverage except the wealthy. At national level Nigeria government has shown commitment to achieving universal health coverage (UHC), but the progress has been slow. For instance, findings revealed that only about 7 million Nigerians are captured by National Health Insurance Scheme (NHIS) while over 160 million people are not covered by NHIS. This makes it imperative for states across the country to set up and run social health Insurance schemes for more citizens to partake and benefit.
A World Health Organisation (WHO) Senior Health Specialist, Babatunde Okunola said only four per cent of Nigerians have access to quality health care without facing financial difficulty. He said this is worrisome considering the sheer number of people that make up the remaining 96 per cent that have been inexcusably excluded from the universal health coverage. "This is worrisome. It explained the reason why Nigeria has recorded minimal success in tackling various health-related challenges including the primary healthcare and particularly the infant and maternal mortality", Okunola said.
One of the health facilities
Interestingly, Oyo State has moved far in its social health insurance programme and the people of Oyo State are already enjoying the benefit of the social health insurance. Many residents of Oyo state who enrolled in the health insurance scheme said it has provided opportunities for them to get medical care without experiencing catastrophic health expenditure.
Akande said OYSHIA is doing great and that there have been 350 vaginal deliveries and 78 Caesarean sessions carried out under the scheme. He said primary healthcare centres accredited for the scheme have been fully upgraded to offer best quality healthcare services to the people of the state.
OYSHIA was set up on 18th August, 2015 and passed into law on the 8th of November 2016, assented to by Governor Abiola Ajimobi in December, 2016 and flagged off by the governor on 25th May, 2017. With a strong legal frame work, the health insurance scheme in Oyo State was made mandatory for all residence of the state. Yet, many residents of Oyo state are still not on the health insurance scheme in the state.
The United Nation Children’s Fund (UNICEF) is providing supports to Oyo State Government through the insurance agency in the interest of children, women and other vulnerable citizens. A UNICEF Health Specialist, Dr. Adebola Hassan said health insurance is very necessary to prevent avoidable death particularly among children. Adebola said the benefits of health insurance are enormous particularly in attaining Universal Health Coverage (UHC) and ensure good health for the people without experiencing out-of-pocket spending when they have health challenges.
Akande added that OYSHIA is funded with 2 percent consolidated fund from the State’s Internally Generated Revenue (IGR) of Oyo state. He said the agency is also getting fund from grants, premium, and philanthropy. He said OYSHIA’s benefit packages include Standard Plan with Option of Top-up, Family Plan and Student Plan.
He said the scheme targets 450,000 enrollees to cover five percent of the population of the state by middle of this year. He commended UNICEF for assisting the state to achieve the target and ensure good health for the people of the state, particularly the children and women. He said OYSHIA has been rated very high in terms of performance and assured that the agency would not relent in making sure that the people of the state enjoy quality healthcare without expending their entire savings on medical bills.
Pregnant women getting treatment
He said some farmers in the rural areas in state who wanted to enrol in the scheme but lack the financial capacity to pay the premium for the enrolment have resorted to giving out their farm produce to the agency in lieu of cash. He expressed worry that many people are still not aware of the activities of OYSHIA and sought the support of the media to propagate the importance of health insurance to the people so that more people would enrol.
According to him, “Many people who would have loved to enrol in our health insurance programmed but lacked financial capacity to pay the premium voluntary agreed to give us yams and palm oil and other farm produce in lieu of cash to be paid for the premium. In the agency, we have set up a marketing section that is helping 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 enrol them”.
UNICEF Communication Specialist, Mrs Blessing Ejiofor said access to quality healthcare is a right of every child and charged the media to assist in reporting issues that would prompt the policy makers to take proactive steps and implement policies that would make life better for children, women and other vulnerable groups.
She stressed the need to create awareness on benefits of health insurance scheme so that children and vulnerable populations would gain access to quality healthcare services without experiencing catastrophic health expenditure.
The Director, Press and Public Relation, Oyo State Ministry of Information, culture and Tourism, Mr Rotimi Babalola also lauded UNICEF for its efforts in ensuring the wellbeing of children and women.