Towards Achieving Universal Health Coverage: Delta State Contributory Healthcare Insurance Scheme, National Health Act and Other Matters
Posted: 10/Jul/2017
Quality health care is one of the most important factor in how an individual perceive his/her quality of life. In most countries, along side the economy, it is the a major political issue. Health is directly or indirectly related to other sector such as food security, house hold income generation, nutrition, employment status and other social security services. This makes health and essential sector in the polity of any progressive society in today’s world. Martin Luther King Jr once said “ of all forms of inequalities, injustice in health care is the most shocking and inhumane”. Despite the fact that Nigeria is striving to achieve global health standards which is measurable by the attainment of the 17 sustainable development goals, the Nigeria health system is still lopped sided due to certain constraints which will be addressed in another article. Health remains an integral part of man’s existence even in the midst of global crisis, natural or man made. The economic crisis rocking the nation today, continues to deteriorate the structure and functions of the already frail health system.
 
Despite the aforementioned above, delta state government under his excellency Dr. Ifeanyi Arthur Okowa, is making laudable strides in efforts towards provision of accessible, affordable and quality healthcare to its inhabitants, this is evident with the creation of the state contributory healthcare insurance scheme, which is the first of its kind by any state in the federation. The bill which was passed by the state assembly in the first quarter of 2016, its a giant step towards health system and capacity strengthening amongst it peers. 
 
It is a program designed where deltans or those residing in the state can make monthly or yearly contributions for healthcare cost, thereby having access to a defined package of quality healthcare services anytime needed. The affairs of the scheme is been regulated by the state contributory healthcare insurance commission which recently was awarded best by the Nigeria health care excellence awards held in Lagos. The scheme creates a financial pool which spreads financial risk in other to ensure sustainability. It is supported by the federal government through NHIS, with contributions also from non governmental organization ,donor agencies and well meaning individuals within and outside the state. Since its inception, January 1st 2017, over 60,000 deltans have registered and have direct access to primary health care across the state , with special provisions vulnerable( maternal- new born, elderly and those with disabilities). The social-economic benefits are enormous as individuals and families will have more disposable income through reduction in catastrophic health expenditures. Existing literatures currently estimate out-ofpocket spending as the major source of healthcare financing in Nigeria.
 
The right to health supersedes other rights, thus providing affordable, accessible and quality healthcare should be a foremost cardinal policy and program of any government, because nation building efforts or national development aspirations cannot succeed or be sustain unless adequate attention is paid to population health.
 
A national health insurance scheme for all can guarantee the attainment of universal healthcare coverage for all Nigerians as contemplated by the national health act, 2014. In the absence of such a scheme, the dream of economic growth and prosperity for all Nigerians will remain elusive. The act provides for the first time an all encompassing legal framework for delivery of affordable, accessible and quality healthcare for all Nigerians. In synergy with efficient health financing system, the ensured quality health services becomes affordable and accessible with the citizens of the nation the ultimate beneficiaries. The national health act strategically defines the comprehensive vision of the health care system that creates value for both patients and healthcare providers and the process required to achieve it. The act was accented by ex-president His Excellency ,Goodluck Ebele Jonathan on the 31st day of October,2014.
 
Prior to that historic moment, stakeholders in Nigeria and diaspora have been lamenting the absence of any legislation guiding the 
3 operation of the national health system . It also Addresses the availability, distribution , capacity development and management of human resources .
 
It prioritize patients by protecting the rights of the client information, provides a mechanism for addressing complaints while stipulating the right and responsibilities of health personnel. It further strengthen health information and research systems, which collectively encourage institutionalization of evidence based decision making while promoting development through research. Its is with no doubt one singular instrument to unlock the economy and the greatest transformation of the health sector. It guarantee the RIGHT OF THE PATIENT AT ALL TIME to take complete charge and also provides access to health care even in the face of emergencies .
 
Arguably , the impact of the nations economic crisis has affected health care delivery, nevertheless, other states in the federation must follow the foot step of delta or even surpass it, if SDG's must be close to achievement in Nigeria, this is calling on the federal government for the full and speedy, long over due implementation of the national health act, for the attainment of universal, durable, efficient , equitable and quality affordable health care for all Nigerians in other to live a mental, social and economically productive and healthy lives free of infirmities. For there to be wealth creation, the populace must be in good health , hence, strengthening the health system should be given Its due attention from all tiers of government and policy makers. 
 
By tackling it crisis and improving its performance so as to prevent the cycle of ill health, poverty and under-development. The central focus of a health care delivery process must be centered on continuously increasing value for the populace, with value defined as “ health outcomes achieved per naira spent”. The time to act is now!!!
 
About The Author:
Evaborhene, Aghogho Nelson is a medical practioner with an interest in healthcare financing and systems, an advocate for universal health for all, writes from Warri, Nigeria.