As Sokoto Moves to Commence Contributory Healthcare Scheme

Following the passage of the Contributory Healthcare Management Scheme Bill into law by the Sokoto State House of Assembly, the stage is now set for the commencement of health insurance in the state, writes Mohammed Aminu

Healthcare finance in Nigeria is characterised by dominance of out-of-pocket payments and lack of prepayment mechanism such as tax and health insurance. Households without health insurance coverage face a risk of incurring large medical care expenditures should they fall ill.

Every second in Nigeria, three people are pushed into poverty because they have to pay out- of-pocket for healthcare. This catastrophic funding exceeds 10 per cent of total household income.

Health insurance is a means of attaining universal coverage which ensures coverage for all people including the poor. It also offers a form of protection where an individual can safeguard himself against all unpredictable and predictable healthcare needs.

The National Health Insurance Scheme (NHIS) was established under Act 35 of 1999 by the Federal Government of Nigeria. The scheme is aimed at providing easy access to healthcare for all Nigerians at an affordable cost through various prepayment systems. However, due to some socio-cultural and economic factors, state governments realised that NHIS does not adequately cover some major areas of healthcare services in their respective states and therefore, started their own respective schemes.

Sokoto State Governor, Alhaji Aminu Tambuwal, in his determination to ensure universal access to quality healthcare by all residents established the Sokoto State Contributory Health Care Management Agency (SOCHEMA) in 2016. SOCHEMA was set up to provide for the indigent, the poor and vulnerable in the state in order to ensure that they benefit from the health scheme.

Sokoto has an estimated population of 5.3 million people with about 4.5 million that need to be provided for by the government and other innovative sources in order to achieve universal coverage. The state government in keeping with the NHIS recommendations would provide subsidy and coverage to the vulnerable and those who cannot contribute especially the indigent, elderly, children under five and pregnant women.

Thus, in order to ensure the take off of the scheme in the state, the Sokoto Contributory Healthcare Management Scheme bill was passed into law by the Sokoto State House of Assembly on February 2018 to ensure universal health coverage which guarantees availability, accessibility and affordability of healthcare services to all residents of the state.

Based on the foregoing, the Sokoto State Contributory Health Care Management Agency swung into action by organising a workshop for traditional and religious leaders in the state to have their buy-in and opinion ahead of the commencement of the scheme. Similarly, a seminar was organised for journalists and media practitioners on components of the health contributory scheme in order to effectively communicate the benefits to the public.

Speaking at a media and communication healthcare financing training for journalists in Sokoto recently, the Special Adviser to the Governor on State Contributory Health Care Management Agency (SOCHEMA), Alhaji Muhammad Ali Inname, said arrangements had been concluded for the take-off of the healthcare contributory scheme in the state. He said the bill establishing the state contributory healthcare scheme had been passed into law by the Sokoto House of Assembly and only waiting for assent by Governor Aminu Tambuwal.

He posited that the Agency had already accredited 21 General Hospitals and 65 primary health centres across the 23 local government areas ahead of the commencement of the scheme. Inname said this was in addition to the recruitment of more staff, training of agency’s staff especially experience sharing with the National Health Insurance Scheme(NHIS) as well as the deployment of information and communication technology infrastructure for enrollment and efficient management of the scheme.

“We have already embarked on massive enlightenment campaigns in the state. We will soon meet with the State Ministry of Health to start deduction and after that we will commence enrollment and registration. So, the programme will be launched in July 2018 by Governor Aminu Tambuwal,” he said.

He stated that the workshop was aimed at deepening the understanding of journalists on the basis of health financing and to improve their knowledge in order to effectively communicate the benefits of the health contributory scheme to the public. Inname emphasised that the contributory health scheme is mandatory for all residents of Sokoto.

According to him, the scheme will not cover all diseases but only certain ailments that are prevalent in Sokoto State. “Diseases that are terminal in nature like cancer are not fully covered in this scheme. The patients will have to make part of the payment of the medical bills. Thus, initially, we will not cover all diseases. “The state government is making efforts to ensure that poor people do not die again because they don’t have money to pay medical bills. So, the mission is to provide access to health services to people without suffering financial hardship irrespective of socio-economic status,” Inname added.

In a remark, the Chief of Party, Health Finance and Governance, Dr. Gafar Alawode, described health insurance as a vehicle for achieving universal health coverage. He said it was a form of pooling of funds to achieve the intended purpose of improved access, financial protection and equity. The Chief of Party, who was represented by Mr. Somto Mbelu, maintained that with health insurance, citizens are protected from becoming poor, having to borrow or sell their property because of severe illness.

Also speaking, Mr. Mainasara Bello of Health Finance and Governance, said healthcare financing is the collection of revenue to pay for the operations of the health system and ensure access to quality healthcare regardless of ability to pay. “Those that cannot pay will have support from the State Zakkat Fund and Consolidated Revenue in the state. It is important to raise enough revenue to have a good health system that delivers quality services to all,” he added.