Mr Ezire Onoriode, the Country Director, Palladium Health Policy Plus Project, an NGO, says health insurance remains the vehicle for quality healthcare and Universal Health Coverage (UHC) across the globe.
Onoriode told the News Agency of Nigeria (NAN) on Tuesday in Asaba that the thinking of the Federal Government was to ensure that all the states establish a health insurance scheme with a functional primary healthcare system.
“I work with Palladium, a US service funded project, working in 17 countries of the world and in Nigeria; we are working with the Federal Ministry of Health.
“We work with the National Health Insurance Scheme (NHIS) and the National Primary Health Care Development Agency and their states counterpart to help them achieve UHC.
“At the state level, we are working in Ebonyi, Osun, Abia and Federal Capital Territory (FCT). We provide technical support for states to develop their health insurance agency and health insurance scheme.
“Globally, if you want to achieve UHC and quality healthcare health insurance is the vehicle to do that this is because there were many who are so poor and cannot afford healthcare.
“Imaging in Nigeria today, out of pocket expenditure is one of the highest in the world at about 77 per cent compared to some countries, like Ghana which is less than 40 per cent out of pocket expenditure,” he said.
He said that health insurance takes the burden away from the poor and spread it across the entire population of the scheme with a minimal contribution to access quality healthcare without the catastrophe of poverty.
“We have currently developed health insurance scheme for Osun, Abia and Ebonyi States.
“Gov. David Umahi of Ebonyi will be launching the state health insurance scheme before the end of September, to open it for the public to access healthcare services,” he said.
He said that theme of this year’s National Council on Health (NCH), “Consolidating the Journey Towards Achieving Universal Health Coverage (UHC)’’, which held in Asaba, was a pointer to the eight directions in Nigeria.
He said that the NHIS at the time it was set up was not made mandatory and as such many people could not get registered into the scheme, adding that it is part of the reasons why the coverage was low logged.
“The Federal Government is trying to make health insurance mandatory, besides when the NHIS scheme started its coverage hovered around federal staff and this constitutes a very small percentage of the entire population of the country.
“I am excited when I learnt that Delta Health Insurance Scheme has recorded over 630,000 enrollees in a scheme which started less than two years ago in a state with about four million people.
“So, imaging if every state can set up the scheme and register up to 10 per cent coverage, many more Nigerians will have access to quality healthcare compared to about five per cent coverage by the NHIS given the over 180 million population of the country.
“The solution is for all states to get their health insurance running and sustainable and from there we can talk of quality healthcare for every Nigerian.
“There is no reason why any woman should die giving birth to a life, this happens to most poor Nigerians because they cannot afford quality healthcare.
“The choice of going to unskilled birth attendance is obvious because they cannot afford the bills to access quality healthcare services and that is the major cause of death among pregnant women but with health insurance, we can stop that,” Onoriode said.
He said that the reality was that there were many families that cannot pay the premium, adding that that is where the government has to make social contributions and need to free resources to accommodate those vulnerable groups.
He said that the government must increase the domestic funding for health, ensure efficiency in the use of these resources, particularly in the Primary Health Care systems, and no white elephant projects.
According to him, it is not a good use of resources for the state government to build many secondary health facilities.
“Reverting to primary healthcare services is the most efficient way to deliver healthcare to the people with minimal funds which will be assessable to the people at the grassroots.
“If that woman that is pregnant at the community level can go to that primary healthcare to receive quality healthcare service, she may never get to a situation where she will need secondary care.
“So, by making our primary healthcare to be functional, by providing needed facilities, engaging enough human resources; nurses, midwives and doctors with their basic salaries paid and operational allowances paid, they will produce tremendous results.
“With this, our secondary facilities will never be crowded and then will provide specialised service that secondary and tertiary institutions need to provide,” Onoriode said.
