By Steve Adeyinka
Health insurance effectively became an operational scheme for accessing the healthcare system within Nigeria in 2005. However, it has become glaring that the scheme is still elusive to majority of Nigerians with just 5% of the population accessing the scheme.
Even more, of the lot accessing it, 70% of them finance their health insurance scheme through out-of-pocket expenditure.It is in this respect that many are looking at the relative success of the scheme in Delta State, where the coverage and financing scheme have been hailed as exemplary.
Health insurance formally came to life in Delta State after the Delta State Contributory Health Scheme (DSCHS) Bill, was signed into law by Governor Ifeanyi Okowa, on February 4, 2016. The bill was one of the first bills sent to the State House of Assembly after Okowa came to power as governor in 2015.
It underlined the priority he was giving to the health sector in his agenda.Before becoming governor, Okowa had earlier acquitted himself as a champion of the sector with accomplishments as commissioner of health in Delta State.It would be recalled that it was during his stint as health commissioner that General Hospitals in the state which were even below dispensing centres were uplifted, with some being turned into Specialist Hospitals.He had followed up his advocacy in that sector with his lead role in the Senate as chairman of the Committee of Health with the passage of the National Health Bill.
That piece of legislation is the comprehensive piece of law underpinning the nation’s health policy.It was as such worthwhile that returning home to Delta as governor in 2015 that Okowa championed the passage of the Delta State Contributory Health Scheme.The significance of the impact of the Delta State government efforts in boosting access to health is underpinned by the fact that more than 10% of all those enrolled in a health insurance scheme in the country are based in Delta State.As at December 2021 with just over 10 million persons enrolled into the different segments of the health insurance scheme in the country, 1,019,461 of the enrollees are based in Delta State. That translates to a coverage of more than 20% as compared to a national average of below 5%.
How Doctor Okowa has been able to put Delta State at the top of access to healthcare, some say, may flow from his background as a medical doctor who started his working life by practicing at the grassroots with a hospital in Igbanke, Edo State. That was before he caught the bug of politics which has now catapulted him to the position of the vice-presidential candidate of the Peoples Democratic Party, PDP.
Remarkably, Dr Okowa’s talent in politics has helped him to also identify good hands to manage the health infrastructure.One of such is the Harvard University trained Dr. Ben Nkechika, health insurance expert, who was head hunted as director-general/Chief Executive Officer of the Delta State Contributory Health Commission (DSCHC). Remarkably, the advances in promoting access to health in Delta State has received the approval of major stakeholders in the country’s health system and notably, UNICEF.
With about 20% of its population enrolled in the health scheme it is thus remarkable that the state could get the approval of UNICEF given the seeming abysmal efforts in many other states, including the rich states like Lagos, Rivers and such.Noting how the Okowa administration was able to make a success of the health insurance scheme, Dr Nkechika speaking during a policy dialogue organized in conjunction with UNICEF last December noted the positives that the good rapport with labour in the state contributed to the success of the scheme in Delta State.
Speaking during the policy dialogue, the Director General, DSCHC, Dr. Ben Nkechika believes the state has made progress in health insurance because it developed a strategy that was bringing better outcomes, adding that political will from Governor Ifeanyi Okowa played a part in it.
He said, “we engaged labour at the conceptualisation stage of the scheme. Several meetings were held with their leaders and at one such meeting; we got to know of their interest and ensured it was accommodated in our planning processes. Thus, labour got involved in our planning and made valuable input and when we were ready to start, resistance was low. The only resistance we got was their fear for quality of healthcare service delivery from government hospitals, which we overcame by enlisting their choice private hospitals into the scheme and enhancement of government hospital service delivery capacity.”
Governor Okowa’s Chief Economic Adviser, Dr Kinglsey Emu who was also present at the policy dialogue also noted how the state government has been able to turn the Primary Health Care system into the cornerstone of its health policy with basic access to all.
Okowa has been able to make his imprint upon the nation’s health system as commissioner with the transformation of the hospitals, as senator with the National Health Bill and as governor with the health insurance scheme. What he could do as vice-president under Atiku Abubakar as president is the desire of all.