COMMUNIQUE ISSUED AT THE END OF A ONE DAY NATIONAL STRATEGIC STAKEHOLDERS ENGAGEMENT FOR ENROLLEES OF THE NATIONAL HEALTH INSURANCE SCHEME (NHIS) HELD AT CHIDA HOTELS, UTAKO, ABUJA ON SEPTEMBER 4, 2019.
The National Health Insurance Scheme (I\ HIS) organized a one day Strategic Stakeholders Engagement for enrollees with the main objectives of unveiling the new-result oriented NHIS landscape, sensitizing enrollees on the modus operandi the Formal Sector Programmes, identifying critical challenges in accessing care by enrollees, clarifying grey areas in the implementation of the Formal Sector Programme, suggesting ways and means of addressing the barriers. The engagement, which had 92 participants from across 77 Ministries, Departments and &genies (MDAs) received presentations and had discussions on the Changing NI IIS Landscape and Enrollees as Critical Stakeholders in the NHIS. The participants had Group work on the challenges of enrollees in relation to (i) Health Care Providers (HCPs), (ii) Health Maintenance Organizations (HMOs), (Hi) Employers (iv) NHIS.
The critical challenges identified by the participants included lack of adequate knowledge of rights and responsibilities by enrolees, Non mandatory nature of health insurance under the current Act, old drug and price lists, out-of-stock syndrome, lack of synergy between HCPs and HMOs, long waiting time to access healthcare, lack of sensitization of Desk Officers, delay in issuance of authorization codes by I IMOs, non-release of enrolee register to IICPs, poor monitoring of I ICPs and I IMOs by NHIS, ineffective communication channels among stakeholders, non-issuance of ID cards, irregular payment of capitation and fee-for-service by NHIS and HMOs, inadequate support of Desk Officers by the MDAs and NHIS, non-re-accreditation of HCPs by NHIS.
The Stakeholders resolved as follows:
- The Management of NHIS was commended for embarking on a re-branding agenda focusing on value system reorientation, engendering transparency and accountability and accelerating the drive towards Universal Health Coverage (UHC).
- In line with the Presidential and Global mandate to achieve UHC by 2030, the Scheme should put in place programmes to cover all segment of the population from cradle to grave beyond the Formal Sector Programme.
- The Scheme should pursue the amendment of its enabling Law to make health insurance mandatory and seek innovative financing mechanism to improve finding to expand coverage (especially the vulnerable) and improve on the Benefit Package.
- There should be regular engagement with Enrollees, Healthcare Providers and HMOs to improve access and quality care.
- Healthcare providers and HMOs should be monitored for compliance with tie NHIS Guidelines and erring organizations should be sanctioned with appropriate publicity to serve as a deterrent to others.
- The exclusion list for diseases covered should be reviewed in view of emerging health challenges.
- The Basic Health Care Provision Fund (BHCPF) should be implemented in accordance with the enabling law while other innovative financing mechanisms to increase funding for Health Insurance should be pursued.
- There should be increased transparency in the operations of HCPs, HMOs, and the NHIS.
- Deployment of ICT by all stakeholders to enhance operational efficiency within the health insurance ecosystem should be pursued as a mailer of priority.
- NHIS, HMOs and HCPs should embark on periodic sensitization and expanded awareness activities via social media platforms.
- The Scheme should put in place Performance Award for deserving HMOs and HCPs
- Toll free lines should be provided by NHIS and HMOs to facilitate engagement with enrolees and obtain feedbacks from them.
- HMOs should embark on sensitization activities in MDAs in accordance with NI-IIS operational guidelines and submit report of same to the Scheme.
- The NI-IIS should urgently review its drug, price list and benefit package in recognition of current realities in the health sector.
The stakeholders' engagement concluded with a commendation to the Management of the NI IIS for holding the programme and stressed the need for such regular interaction with stakeholders. The expectation is that these resolutions shall be implemented in the spirit of the result oriented NHIS.
Signed for the COMMUNIQUE COMMITTEE:
Mr. Olufemi Akingbade
General Manager/Zonal Coordinator, Lagos Zone, NHIS
Dr. Alkali Umar
Director Public Health, Planning & Research, National Assembly