Committing to Contributory Healthcare in Delta

By Ben Nkechika

Universal Health Coverage is a healthcare system that provides healthcare and financial protection for all citizens enabling financial risk protection and improved access to quality health services when needed, leading to better health outcomes. It functions within the dynamics of who is covered, what services are covered and at what cost.

There is a growing evidence that the most equitable and sustainable way of achieving better health outcomes, is through the Universal Health Coverage. It progressively save lives, increase economic growth and bring prosperity to all citizens.

Evidence has shown that out of pocket expenses at the time of seeking healthcare service, impoverishes families and put them in sustained debts.

The Delta State Government has made achieving Universal Health Coverage a priority objective and one of the pathways to end poverty, boost shared prosperity and ensure access to quality and affordable healthcare service for all residents of Delta State.

The Government of Delta State under the administration of His Excellency, Senator Dr. Ifeanyi Okowa has established the Delta State Contributory Health Scheme as the mechanisms for achieving Universal Health Coverage in the State with the objective to ensure that every resident of Delta State has good access to healthcare services and to ensure that all residents of Delta State have financial protection, physical access to quality and affordable health care services

Other objectives include to protect families from financial hardship of huge medical bills; limit the rise in the cost of healthcare services; ensure equitable distribution of health care costs across different income groups; maintain high standard of healthcare delivery services within the health scheme; ensure efficiency in healthcare service delivery; improve and harness private sector participation in the provision of healthcare services; and ensure adequate distribution of health facilities within the state.

Others include to ensure appropriate patronage at all levels of the healthcare delivery system; ensure the availability of alternative sources of funding to the health sector for improved services; and in cases where residents do not have available medical and other health services, to take such measures as are necessary to plan, organise and develop medical and other health services commensurate with the needs of the residents.

The Delta State Contributory Health Scheme (DSCHS) commenced operations on the 1st of January, 2017 with the transition of the free maternal and free under five programme of the Delta State Ministry of Health to the Delta State Contributory Health Scheme (DSCHS), representing part of the Equity Health Plan of the Health Scheme.

From January 2017 to October 2017, 46,172 pregnant women and 77,442 children under five years (Total 118,614) have been registered with the scheme, and are receiving care in accredited healthcare facilities across the state.
Registration and validation of Biometric data for the 47,321 Civil and Public Servants in Delta State has also commenced along with their contribution and counterpart contribution on their behalf by the state government as well as provision of healthcare service at accredited healthcare facilities under the scheme.

Registration and payment of Premium by the Informal Sector Groups commenced on the 1st December 2017 across the state along with an elaborate advocacy and sensitisation program for stakeholder support and buy-in. The Commission has conducted Town-hall meetings with the various trade unions, President Generals and Secretaries of all Towns and villages in Delta State, Media broadcast in both print and electronic media and other information dissemination programs.

The Bill establishing the Delta State Contributory Health Commission (DSCHC) and a Mandatory Delta State Contributory health Scheme (DSCHS), was passed into Law on the 9th of December 2015 by the Delta State House of assembly after going through the appropriate parliamentary procedures and signed into law by the Governor of Delta State Senator Dr. Ifeanyi Okowa on the 4th of February 2016.

The state through the DSCHC had earlier conducted a Baseline Assessment survey that determined key household demography and health seeking behavior of Deltans to guide planning for expanded health insurance coverage; determined the current household spending on health, health insurance coverage needs and willingness to pay for health insurance in Delta State; estimated the proportion of Delta State residents in the lowest socio-economic quintiles, to guide decisions on subsidy and or exemptions from payment; assessed the availability and capacity of health delivery facilities in Delta State to deliver proposed health insurance services and assessed the readiness of health facilities to deliver proposed services across all 25 LGAs. The Baseline Assessment Survey report is available at the Commission website www.dschc.org.ng along with the Law establishing the Commission.

To ensure a diversified registration and premium payment option, the Commission has deployed an ICT platform in partnership with Interswitch and eCLAT Health, utilising customised solar powered desktop computers and Android devices with embedded Electronic Medical Record (EMR) and Treatment Protocol software that will assist healthcare personnel at the PHCs in their service delivery capacity and provide several premium payment options that include Quickteller, POS, ATM, Cash at bank, and Webpay for an effective and efficient management of the Scheme processes.

To drive efficiency, spur creative and disruptive innovations that will ensure visible health impact and outcomes in Delta State, the Commission adopted “HeFAD” (Health for all Deltans) as a result based Policy Programme statement to guide its policies and strategies for the implementation of its mandate of ensuring access to quality and affordable healthcare services for all resident of Delta State irrespective of their socioeconomic status in the society.

“HeFAD” will be the convergence of health policies in Delta State designed to deliver a cost effective and efficient healthcare service that will invariably promote the Universal Health Coverage in Delta State within the context of the National Health Insurance Scheme and National Health Act 2014.

Dr. Nkechika is the Director General/ Chief Executive Officer, Delta State Contributory Health Commission