By Perpetua Onuegbu

ONE Campaign, a Non-governmental Organisation (NGO), has called for the accreditation of private health providers in the National Health Insurance Scheme (NHIS) to increase beneficiary choice.

Dr Olumide Okunola, Senior Health Specialist, World Bank, said this at the Public Launch of State of Primary Healthcare Delivery in Nigeria Report on Tuesday in Abuja.

The report was carried out by ONE Campaign in collaboration with other organisations such as the World Bank, Nigeria Health Watch, National Advocates for Health, and African Health Budget Network among others.

The report which was released at stakeholder event in Abuja provides an in-depth and systemic review of the implementation of the Basic Health Care Provision Fund (BHCPF).

Compliance of the states with the National Health Act and National Health Policy, and a ranking of health system performance reveals the state of primary healthcare delivery across the 36 states and the Federal Capital Territory (FCT).

The research also included recommendations for how state governments should strengthen their fragile health systems, enhance the existing implementation of the BHCPF.

And raise strategic and operational planning for health in order to promote access to and utilization of primary healthcare services.

According to Okunola, among the findings of the report was that private healthcare providers are not accredited for NHIS.

This he said does not give beneficiaries opportunities for quality choice in healthcare delivery.

‘’The NHIS has done one thing in this last two years, it has given automatic accreditation to all public PHCs but there is also a down side to that, as of today not a single private provider is accredited under the PHPF.

“It is a down side depending on what side you are looking at this from because about 60 per cent of our people depending about 60 percent get their services from the private sector.

“That is one key thing we need to begin to question and see how we can expand this to include the private sector and increase the beneficiary choice.

“And that will be an additional incentive for this public places to increase the quality of services there.

The World Bank Specialist said the quality framework must be worked on also noted that the report showed the public PHCS are put under the management of facility management committee with chairmen that see their position as political appointment.

According to him such people when money comes in for the benefit of the facility wants a cut from the money.

“Another quick point to note is that on the NHIS gateway monies are allocated based on an identified individual or enrollee, there is as of today, no commonly agreed framework for identification and enrollment of the poor and venerable.

“Even though Nigeria has what is gradually emerging as the best national social registry in the world, that national so registry today has 50 or so million Nigerians identified and enrolled.

“If this Nigerians are covered then we could be said to have achieved to have achieved universal health coverage but this has led to a huge delay in the NHIS gateway because of disbursement from states,’’ Okunola said.

He, therefore, called for a review of national healthcare delivery across the country.

Dr Chijioke Kaduru, Member, Supervisory Board, Corona Management Systems one of the producers of the report said it helped in accessing the implementation of the basic health provision fund.

“What this report has done is to help us access how well we are implementing the basic healthcare provision fund, and how that fund is helping to translate to good for the people.

“The key thing this report has shown us is that, things are not good, but there is reason to be optimistic, because we have a unique opportunity to build on the work that has happened over the last few year.

“So the report is not to name and shame people, but is to show where there are gaps and for all of us who work together to start to improve and close those gaps.

“The key methods that we use are really reviewing state’s own reports, reports that they put out and the reports that were submitted to the National level and the report of their work in general.

“As well as to consult with the few stakeholders in the state level and at national to understand some of those reports to help us get the findings,’’ Kaduru said.

He said the challenges were different from state to state, adding that each state had its own peculiarities.

He said the essence of the report was to encourage state governors and state commissioners the need to look at the problems that the report has found in their states and do something about it.

Kaduru called on state governments not to depend on only their work alone but get citizens experiences and feelings to ensure quality health delivery.

“This is this year’s report, the collection of the data finished at the end of last year. So that’s why the report covers 2019 to 2021.

“So, the next one of the reports will now cover 2022. So everybody has an opportunity to start to improve now given, so by the end of 2022 when we are collecting the data, we will be able to capture them.

On his part, Mr Edwin Ikhuoria, Africa Executive Director, ONE Campaign, said the purpose of the report was to make state governments proactive in health delivery.

According to him, it took 10 years of consistent advocacy to get the national health act passed.

“Because, most primary health care centres across the country were in terrible state. So our idea then was that, if you put enough funding it will improve things and so ten years of advocacy eventually got the act passed in 2014.
The reasons why you see we put the report together to say let us show what states actually are doing to make sure they provide services to their people especially having taken so many years to campaign for funding to come.

“So that’s what we did so in turn of the criteria they are many things so the basic health care provision fund has guidelines, it was established, there is the NHIS, Health insurance gateway.

“What we now saw was that, some are reluctant some did not care, some are doing so well so because of the difference in the way the states were responding to this we thought.

“We need to show the world what is happening basically, how the states really care about their own people,’’Ikhuoria said.

The Chairman of National Advocates for Health Group, Mr Muhammad Usman, called on the government to provide the required leadership to ensure that primary healthcare is improved across the country.

According to him, the Federal Government must ensure timely release of funds allocated for the Basic Health Care Provision Fund and effective utilization of the same at the sub-national level to improve primary health care performance.

While unveiling the reports, Sen. Ibrahim Olorigbe, Chairman, Senate Committee on Health, called for huge funds to be advocated for venerable groups.

Oloriegbe said the report should be a check to do the right things, demanding from every candidate to be committed to social services.

He called on the advocates to give the masses a voice and not focus alone on president, governors or National Assembly members.

The News Agency of Nigeria (NAN) reports that five states were awarded for good health service delivery, Delta, Ekiti, Anambra, Enugu and the FCT, with the FCT coming first and Delta the fifth.(NAN)