By Victor Nwegede, Abakaliki.
In full cognizance that health is wealth, Governor Francis Nwifuru has taken a giant step towards redefining his health visions for Ebonyi citizens through the Ebonyi State Health Insurance Scheme, EBSHIA.
The governor in his People's Charter of Needs mantra underscored the infrastructure overhaul of the three tiers of healthcare delivery in Ebonyi State during the 2023 general election campaign. In his words, some of them were the virology centre, a world-class referral hospital with centres of excellence - the David Umahi Federal University of Health Sciences and Teaching Hospital, Uburu and the thirteen general hospitals including the magnificent new Federal Teaching Hospital Abakaliki complex built by the past administrations.
Nwifuru has however, promised to re-establish Ebonyi State University Hospital Abakaliki, improve service delivery in the general hospitals, staffing and equip the existing primary health care development agencies to enhance quality services and as well strengthen the midwife service scheme.
He further assured that his administration would introduce regular free medical outreaches and healthcare awareness campaigns, especially in underserved areas.
Another promise by the governor was to collaborate with healthcare professionals, faith-based organisations and development partners in healthcare delivery and to enhance the capacity of healthcare professionals through exchange programs and training.
Also, to introduce a medical volunteers service scheme to support health care delivery in the state, provide a government community health scheme for the less privileged and vulnerable ones, support the Ebonyi State Health Insurance Scheme (EBSHIA) and equally provide health insurance for Ebonyi indigenous 80 years and above.
Translating his visions into realities, Governor Nwifuru after his inauguration on 29th May 2023, has demonstrated much commitment to revitalize the health insurance in Ebonyi State.
In a press briefing on Friday at Abakaliki, the Executive Secretary of EBSHIA, Dr Divine Igwe commended Governor Nwifuru on his achievements through the State Health Insurance Agency in his one year in office.
On assumption of office, Igwe said, significant steps and activities were planned and executed, to revitalise the health insurance agency through the state government interventions.
He explained that the Ebonyi State Health Insurance Agency was reactivated to serve its purpose which is to minimize catastrophic expenditure on health by the residents of the state which enhances more access to health leading to the actualization of Universal Health Coverage (UHC).
This oversaw the harmonization of the activities of EBSHIA and the creation of additional units such as an informal sector unit, marketing unit, community mobilization unit, formal sector unit, TISHIP unit, call centre unit, documentation unit, claims management unit, ambassadorial and state equity fund unit, local government area desk officers and reception attendants.
It brought about the introduction of digitalization of the agency for easy operation and accountability framework.
Awareness creation was embarked on by the agency because the name EBSHIA, according to the Executive Secretary, was strange to people and so he and his team decided to carry out community, market and church sensitization, making EBSHIA a household name in Ebonyi State today.
To ensure excellent health service delivery and attain favourable partnerships, EBSHIA paid advocacy visits to groups and individuals including Governor Nwifuru, his Deputy Governor - Mrs Patricia Obila and the Governor's wife - Mrs Ukamaka Nwifuru, the Agency's Executive Secretary further explained.
During the agency advocacy visit, over 80 per cent of the political appointees, individuals and organisations including the labour leaders, the university communities, faith faith-based organisations among others were reached for partnership.
The agency as a result of the positive steps by the Executive Secretary and team has changed from manual operation to digital operation.
Now, registration into Health Insurance can be done even with a phone and payment can be made through pay stack.
Claims can be managed online. Capitation can be generated online. Reports can be given online. Online enrolment is the new trend in EBSHIA.
To ensure self-registration, the agency introduces biometric enrolment, with secured data saved in the cloud and server. An individual subdomain is created in the agency's portal for ambassadorial health insurance.
To increase service providers and create a provider network, EBSHIA added two private facilities each across the 13 local government areas making an additional 26 service providers for easy referrals.
EBSHIA secured accreditation and partnership with FETHA and NOFIC (National Obstetrics Centre) for Tertiary service provision. The agency initiated the service providers’ network for both the primary, secondary and tertiary device providers.
For facility or revitalization, 75.25 per cent of all the funds that go to the agency return to the Primary Health Centre, PHCs and other hospitals through capitation and fee for service. This is to ensure continuous availability of essential drugs, human resources and others.
Igwe who enumerated the achievements of EBSHIA under the Nwifuru-led government recalled that the State Governor currently enhanced the referral process from primary to secondary facilities by employing health workers in the general hospital, incentifying the doctors with brand new SUVs, N150,000 monthly vehicle maintenance.
"He (Governor Nwifuru) also purchased ambulances for the general hospitals. He also approved N11.5 Billion for equipment and consumables in the general hospitals.
"He did not stop there, He started working on the rural roads to ensure quick access to the hospitals. The agency further accredited 26 private facilities including NOFIC, DUFUTH and FETHA as supportive facilities.
"On recruitment and training, apart from the main staff of EBSHIA, 27 Ad-hoc staff were recruited to carry out the activities that were lagging.
EBSHIA trained and retrained all staff on, Microsoft usage, Marketing strategies, Health insurance operation in Nigeria, Digital solutions, acts of community engagement and resource mobilization.
Training of 205 Health Workers in the operationalization of Health Insurance in Ebonyi State.
"Training of ward development committee chairmen for proper identification of vulnerable groups in villages. Combine training of health workers, WDCs and Admin Secretaries for operationalization of health insurance (IHP-supported training).
Training of 136 enrolment officers for enrolment of 60,000 vulnerable persons across the 171 political wards in Ebonyi State (IHP Supported training) and training of the call centre unit on local communication for rural dwellers," Igwe said.
Speaking on financial allocations, Igwe noted that EBSHIA was able to collaborate with the entire government structure for easy operation of health insurance in the state.
In his words, the Governor of the state being a health-friendly Governor approved the release of the BHCPF counterpart fund, N39,000,000 and also approved N 200,000,000 for vulnerable group health insurance premiums.
He further disclosed that Nwifuru released monthly N37,000,000 for State Civil Servants (ONWA Health Care) Health Insurance by the BHCPF is an offshoot of the National Health Act 2014 section 11.
On enrollment into the Basic Health Care Provision Funds (BHCPF), Igwe asserted that "before March 2024, BHCPF counted 51,871 enrollees.
"Nevertheless, the ongoing enrolment into BHCPF is 60,000 enrollees, while the State Equity Fund (SEF) – has 13,000 enrollees, but the formal Sector - 8,000, informal sector and others – 3400, and PHC challenged Fund – 560.
"In all, 136,831 enrollees have benefitted in health insurance within one year of Governor Francis Ogbonna Nwifuru being in office.
"Out of this number, pregnant women in the current enrolment is 9,000 children under 5 years are 15,000; others include PWD (People with Disability) and Indigent."
Enumerating the service utilization through EBSHIA, Igwe stated that the Nwifuru-led government has given some health services free of charge to the beneficiaries across 171 political wards of the state.
He enumerated the health-free services to include 4,608 reserved immunization-free, 3,056 free normal deliveries, 50 free caesarian sessions, 20,228 free malaria treatment, 3,612 free hypertension management, 943 free diabetes management, 12,665 respiratory tract infections managed, 5,628 free diarrhoea managed, 1,583 urinary tract infections managed, 100 free Herniorhaphy done (100 other surgeries including Appendectomy, myomectomy and hydrocelectomy done.
The State Executive Secretary noted that EBSHIA's partnership with the office of the wife of the governor, Mrs Uzoamaka Nwifuru, out of the 4076 pregnant women enrolled, 341 have delivered.
He added that through the same office, EBSHIA harvested 100 elderly males living with scrotal hernia across the 171 wards of the state for operation. It is already completed.
On integrity assessment, he said, EBSHIA conducted standard and quality assurance visits to all facilities and hospitals for quality enhancement.
The agency also conducted monitoring and evaluation of all facilities for data collection, data validation and proper reporting.
To sustain effective health service delivery, he said, EBSHIA launched different programs including organized stakeholders’ consultative forum meetings, primary service providers meetings and training.
The agency also organized secondary and tertiary service providers meetings and training, enrollees service utilization and testimonial conferences, WDCC meetings and training, and SOC meetings.
EBSHIA organized the first Health insurance summit in Nigeria. In carrying out the activities, Igwe said, EBSHIA increased its bond with USAID-IHP (United States International Development Agency, WHO (World Health Organisation) and BERWO - the Better Health for Rural Women, Children and Internally Displaced Persons, the pet foundation of Ebonyi First Lady.
Through the partnership, IHP supported EBSHIA in hosting CSO (Civil Society Organisations) non-residential meetings, trained enrolment workers and engaged the legislators in a 2-day residential meeting.
The agency also engaged the local government chairmen in a 2-day residential meeting and hosted the flag off of a formal sector health insurance program in the state.
Igwe disclosed the ongoing negotiations regards TISHIP - to integrate all tertiary institutions that are state-owned into health insurance by utilizing the medical fee already incorporated into their school fees.
The Executive Secretary of EBSHIA has therefore described Governor Nwifuru as the Health Ambassador of the Nation in considering his achievements in the health sector in one year in his office.
