- Warns HMOs, Health Facilities To Stop Shortchanging Enrollees
By ‘Dotun Akintomide
To deliver on its core mandate of providing accessible, affordable and qualitative healthcare to Nigerians, the National Health Insurance Scheme (NHIS), Lagos State has called on all stakeholders in the health sector to make meaningful contribution to the scheme to enable Nigerians access quality healthcare services.
At a stakeholder forum organized to address all challenges undermining operational efficiencies in the scheme, key stakeholders including enrollees were brought together to proffer solutions on way forward towards a better service delivery, as well as create proper awareness among the Lagos populace.
The State Coordinator, NHIS Ikeja Office, Mrs. Aisha Haruna in her opening remarks said the scheme has suffered setbacks in the past due to lack of adequate information and robust engagement with Nigerians to outline the numerous benefits of enrolling with the scheme to access health insurance cover. Hence, the need for a stakeholder forum to keep on advancing the statutory obligations the scheme owes Nigerians.
“We believe it’s important to keep on creating avenues whereby meaningful engagement would be made possible among enrollees, Health Management Organizations (HMOs), managers of health facilities and other stakeholders in the health sector.”
Speaking at the event, the National President of Health Care Providers Association of Nigeria (HCPAN), Dr. Umar Oluwole Sanda who chaired the forum posited that, in spite of the prevailing challenges faced by the scheme, Nigeria cannot afford to lose out on the several gains which have been made possible in the health insurance sub-sector since the inception of NHIS in 2005.
“Adequate awareness is key to the success of the scheme and I implore the Lagos office of NHIS to further spread awareness campaigns to all parts of Lagos, especially the remote communities.”
For efficient health care delivery to enrollees of the scheme, the Principal Manager, Formal Sector, NHIS, Mr. Sesan Gbadamosi who spoke on the “Impact of Proper Accounting System in Relation to Accredited HCFs under NHIS Programmes,” observed that several accredited health facilities have failed to open a separate bank account for NHIS operations, lamenting that the lack of proper record keeping and non- adherence to operational guidelines by facility managers and HMOs have continued to stifle the scheme’s growth and development across the country.
Speaking on behalf of enrollees in Lagos, Mr. Increase Otoborkeyan, an official of the Federal Road Safety Commission (FRSC) who shared his perspectives on “Enrollees Experience in Accessing Care under Social Health Insurance Programme” identified the lack of circulated information as the major drawback bedeviling the scheme, saying, “this has made health facilities and HMOs take undue advantage of the enrollees to the detriment of the programme’s objectives.”
Otoborkeyan identified other challenges causing operational setback to the scheme as low awareness among Nigerians; Non-payment of health facilities by HMOs; administrative inefficiencies and hostile attitude of health workers at the nation’s hospitals; non-provision of ID- cards to identify enrollees at health facilities and charging of more than 10% fee on drugs by health facilities which is at variance with NHIS operational guidelines.
He said, “ The programme has been riddled with corruption which explains the reason why enrollees have not been properly taken care-of as against the accessible, qualitative and affordable healthcare delivery which are the clear mandate of the scheme.”
On her own part, Head of Department, formal Sector, NHIS Ikeja office, Mrs. Chika Amahalu frowned at the attitude of healthcare providers who make health care inaccessible for enrollees to desist from such acts, warning that such providers should quit the scheme if they cannot offer quality service to beneficiaries as insincerity has dire consequences on the image of the scheme and the believability of prospective enrollees to enroll in it.
According to Mrs. Amahalu, “30% of NHIS enrollees doesn’t know their hospitals, yet HMOs are being paid” for the values they failed to provide.
She added that “despite enrollees entitlement to only pay 10% on drugs, health facilities have been collecting more, leading to extortion of enrollees.”
Similarly, the Coordinator, NHIS Ikeja State Office, Mrs. Aisha Haruna while calling for stakeholders’ transparency towards the advancement of the scheme mentioned that non-provision of proper bank account dedicated for the remittance of capitation by health facilities has continued to pose serious challenge to NHIS, making HMOs unable to make proper account of service charges.
Commenting further, she averred that the scheme can only live up to Nigerians’ expectation, if the complicity “of the HMOs by not making available to NHIS, the accurate number of enrollees and other crucial data is being put under check.”
Earlier, the Director of Clinical Services/Training, Lagos State University Teaching Hospital (LASUTH), Dr. Ayo Adedokun commended the Lagos office of the scheme for its several programmes aimed at enlightening Lagos residents on the importance of enrolling for health insurance coverage under the scheme.