By Abujah Racheal

The Forum of CEOs of State Social Health Insurance Agencies in the country, says Nigeria has made significant progress toward achieving universal health coverage by establishing state social health insurance schemes.

The Chairman of the forum, Dr Simeon Onyemaechi, who is also the Managing Director/CEO of Anambra State Health Insurance Agency, said this in an interview with the News Agency of Nigeria (NAN) in Abuja.

Onyemaechi said the schemes, implemented in all states except Rivers, were aimed at providing affordable and accessible healthcare for all Nigerians.

“Currently, Nigeria has the second worst out-of-pocket health expenditure globally, with nearly 70 per cent of healthcare costs being paid directly by individuals.

“This has resulted in limited access to necessary healthcare services and has pushed many citizens into financial hardship and poverty,” he said.

Onyemaechi emphasised that Nigeria, currently ranking second globally in out-of-pocket health expenditure, has witnessed positive changes since the introduction of the State Social Health Insurance Scheme in 2016.

Over 5.5 million Nigerians have gained access to healthcare through various programs, including the formal sector, informal sector, and equity programs.

He further noted the success of the Basic Health Care Provision Fund, benefitting over 2 million vulnerable Nigerians in Primary Health Centres across states.

This has contributed to a notable increase in health insurance coverage, rising from less than three percent in 2016 to approximately seven percent today.

While acknowledging the role of the forum in promoting peer learning and strategic engagement among sub-national health insurance agencies, Onyemaechi noted the need for sustained efforts to achieve the 2030 goal of universal health coverage.

He highlighted the Lancet Commission report’s recommendation for the establishment of State Social Health Insurance Schemes as a crucial solution to Nigeria’s health financing gap.

Onyemaechi urged attention to be drawn to the issue, emphasising the importance of placing universal health coverage on the political agenda to ensure continued progress in improving healthcare access for all Nigerians.

(NAN) www.nannews.ng

Edited by Emmanuel Yashim

By Aderogba George

Mr Runcie Chidebe, the Executive Director of Project Pink Blue, an NGO dedicated to cancer awareness, has called on the Federal Government to take swift action in reactivating all cancer treatment centres across Nigeria.

Speaking in Abuja on Saturday after a road walk to mark the 2024 World Cancer Day, Chidebe emphasised the pressing need to address the non-functional state of many cancer treatment centres nationwide.

Chidebe revealed that several cancer treatment centres, particularly in the south-south zone, lack government-owned radiotherapy machines, with the only available machine owned by a private individual.

He commended the government for providing the Human Papillomavirus (HPV) vaccine for cervical cancer prevention but stressed the importance of decentralising cancer control efforts.

“There is a need for the Federal Government to decentralise cancer control… States must take up responsibility in the protection of cancer patients,” Chidebe asserted, advocating for the establishment of Cancer Institutes in each state.

Expressing his excitement about the 2024 World Cancer Day celebration themed ‘Close the cancer care gap,’ Chidebe acknowledged the government’s efforts but highlighted persisting gaps in cancer care.

He emphasised the significance of early detection and treatment in saving lives.

Chidebe urged the government to include screening in the Basic Primary Health Care Provision Fund (BPHCPF) to make it a fundamental aspect of healthcare.

He emphasised the financial burden of cancer care, calling for increased efforts to make treatment more accessible.

Dr Muyi Aina, Executive Director of the National Primary Health Care Development Agency, praised Project Pink Blue for its road walk initiative, emphasising the importance of cancer prevention and early detection.

Dr Zainab-Shinkafi Bagudu, wife of a former Governor of Kebbi State, called for increased awareness and care for individuals already diagnosed with cancer.

She stressed the need for equity in cancer diagnosis, irrespective of status or religion, and urged the government to provide necessary equipment for effective cancer care.

Mrs Ijeoma Osuji, E-Commerce Manager at Transcorp Hilton, reiterated the organisation’s continuous support for Project Pink Blue, emphasising their commitment to cancer awareness and early detection initiatives since 2016. (NAN) www.nannews.ng

Edited by Vivian Ihechu

By Folasade Akpan

Prof. Mahmud Raji, Chief Medical Director of National Hospital (NHA), Abuja, has advised the National Health Insurance Authority (NHIA) to review insurance tariffs to reflect current realities.

“The premium should be reviewed upward to reflect the times and give better coverage to enrollees,” Raji told the News Agency of Nigeria(NAN) on Sunday in Abuja.

He observed that the last time the tariff was reviewed was several years ago.

“Considering the fact that the prices of commodities have quadrupled, the review is very important.

“As at the time the current tariff was put in place, a dollar was N150; now, it is well over N1,400.

“Medications we procure are hugely from out of the country and in dollars.

“So, when the money allocated for medication is, say N1,000 per patient, and then the medications that we have to dispense are N10,000 or N20,000, how do you expect the hospital to just keep doing that?

“We still do that to an extent, which is the reason why sometimes we still have the issues of not being able to pay our vendors.  That gives us the recurring problem of patients saying they are not getting what they are asking for.

“The Federal Ministry of Health, or probably the Federal Government, will need to sit down and restructure the tariffs of NHIA from what we have now.

“I say this on behalf of all hospitals, most especially teaching hospitals and tertiary hospitals. It is really not realistic and that does not only stop at the cost of medications, it goes down to all cost of services offered by NHIA.”

NAN reports that the scheme is a social  healthcare programme designed by the Federal Government to complement sources of financing the health sector and to improve access to health care for the majority of Nigerians.

Set up by Decree 35 of 1999 (now Act 35), it operates on a Public Private Partnership arrangement focused on providing accessible, affordable and qualitative healthcare for all Nigerians.

On May 24, 2022, it was officially gazetted by the Federal Government as the National Health Insurance Authority(NHIA).

On the need to improve the health sector to cater appropriately to the healthcare needs of Nigerians, Raji said that a holistic approach must be employed, adding that government would not do it alone “with the present state of things”.

“Government alone cannot do everything. It has too much in its hands.

“Equally critical issues like security, education, roads all compete for government’s limited resources. Insecurity, alone, adversely affects all sectors.

“Also, our economy is a consumer economy and not a producer economy, so the government is not likely to gain as much money.

“Government does not have so much but yet has so many things it needs to take care of, so it is unfair to say the government must be able to fund healthcare fully.

“So, as the government is trying to do its little bit, other Nigerians have to do their bit.

“The sectors of government that have been empowered to do what it takes to bring in investors into the country to improve the economy, to ensure that there is security, should also do their part.

“When everybody is doing his or her part, we shall build the right synergy and everything will fall into place.”

He opined that to improve on healthcare delivery, private investors must be involved as the government alone may not be able to fund healthcare fully as it would wish.

“It clearly means that private sector funding must come in,” Raji declared.

He added that other international bodies would have to make an input, while other Nigerians, who are well to do, would also have to come in either through philanthropy or Public Private Partnership arrangement.

He agreed, however, that the healthcare industry should be critically looked into.

According to him, pharmaceutical companies will need to be set up, especially since a number of pharmaceutical companies have left Nigeria.

“These gaps should be filled by Nigerian companies so as to reduce the cost of medication and improve the reach and quality of medication that Nigerians would have access to.

“So, when you think about companies producing vaccines, Nigerian companies should be able to do that. We have what it takes, we have the manpower, the land and whatever it takes to do that.

“When we look at heavy equipment like MRI, CT Scans, X-Ray machines and all those big machines that we use in healthcare, even if we cannot manufacture them from scratch, at least Nigeria should have an assembly plant so that they are cheaper and more accessible.”

The CMD said that Universal Health Coverage for all Nigerians should be ensured.

“But to do that, there has to be a realistic pricing of costs of services,” he pointed out.

He said that with UHC, each of the nation’s 220 million people would be covered to receive appropriate healthcare.

“So, you can imagine if all of these people will now come into a certain hospital in their locality. That hospital will be swamped, except if each hospital will be reimbursed.

“If they can be reimbursed, it will also serve for them as a form of revenue.

“So, these hospitals will, on their own, be able to thrive. I think that those are ingredients that once we put them in order, we should be able to have a sustainable, universally accessible health care in the country.” (NAN)

By Folasade Akpan

Prof. Muhammad Raji, Chief Medical Director of the National Hospital, Abuja, on Sunday dismissed allegations that the facility was fond of turning back patients in critical conditions.

“The National Hospital doesn’t reject patients. It cannot do that,” Raji told the News Agency of Nigeria (NAN) in an interview in Abuja.

He added that as a medical director of any public hospital in Nigeria, one is expected to receive many of such reports.

He highlighted possible situations that could give rise to such allegations.

“Sometimes, when a patient is brought in and rushed to the emergency ward, it may be filled up.

“The hospital caters for not only the Federal Capital Territory (FCT), but all the surrounding states and the whole nation, so demands may exceed the capacity of its emergency room.

“It means it may not be able to cater for the population that may come in at a time.

“You should also remember that we bear the burdens from other hospitals as well as when they refer patients to us.

“There are times that these patients may come and there are no bed spaces available, especially during festive seasons.

“When this happens, we try to place a call to sister hospitals to see if there are spaces and then refer them, but people will complain because they always prefer to stay in the National Hospital.

“However, when it comes to the issue of trauma, our hospital is the first that established the National Trauma Centre.

“The centre never sends away patients even if the hospital is full; we have created areas that we call triage areas. They are expandable areas where we can accommodate a number of patients.”

Raji said that though the hospital collects fees, patients still access care without making payment and would still be treated.

He added that during emergencies, millions of Naira would have been expended and no one would ask them for any money up till the time they are stable enough to move to the ward.

“When they go there, they spend the number of days they need to, some of them to the Intensive Care Unit where each day will cost millions of Naira, but at the end of it, patients may not have the money to pay.

“Sometimes, nobody even comes to identify the patient and talk less of paying the bills, but we will have to let the patient go.

“We waive millions of Naira everyday here, but you will never hear the good side of what we do, it’s only when there is a complaint that it is taken over and blown out of proportion, sometimes with a lot of lies built into it.

“Every single day, workers of the hospital do so many heroic things that people never hear of.”

On pharmacy always lacking drugs, he said that in most government hospitals, there were issues with the pharmacy.

According to him, people think that there is a budgetary release for the pharmacy and expect that when they go to a public hospital, medications should be relatively free or very cheap compared to outside.

“That is not so as the government does not give any budgetary allocation for pharmaceutical drugs.

“It is what the hospitals are able to make that they are now able to procure those medications with.

“What happens is that when you procure a medication as a hospital, you are supposed to pay the contractor or the vendor after sales are made from patients.

“Unfortunately, you have this money coming in trickles. You may supply medications for, say N10 million, and then patients will not come in one day to buy these medications.

“They come in trickles and as they come in trickles, there are also some other needs of the hospital.

“One particular need is power (electricity). If you spend one week here, there will not be a power outage for more than five seconds, the most it will push would be half a minute.

“That means when the grid goes off immediately the generators are put on.”

The CMD said that the hospital has huge generators that consume large amounts of diesel and that every month it spends about N100 million on power which is not allocated for, in the budget.

“It has to be from that money that you get from here and there and if the power is not on, you may lose patients in the intensive care unit who are on ventilators.

“You may also lose children that are in the incubators or precious babies on assisted delivery.

“So, you cannot afford to stay without power. You have to get money from the pharmacy or from wherever to pay for electricity.

“Unless you have some more money coming in, you may not have enough money to pay those contractors on time.

“When that happens, these contractors eventually would say since you have not been able to pay me on time, they also will not be able to supply your medications until you pay; so, there is that delay.

“However, with this new administration, we have sat down to restructure things starting from January 1; with that restructure, come back by February, you will see that things are likely to change.” (NAN)

Edited by Ephraims Sheyin

By Folasade Akpan

The Chief Medical Director, National Hospital, Abuja (NHA), Prof. Muhammad Raji, says the facility’s initial mandate of taking care of women and children’s medical needs has been expanded to include the nation’s President.

Raji told the News Agency of Nigeria (NAN) on Sunday in Abuja that the hospital now caters for all the citizens of Nigeria irrespective of race, age, or gender.

“The facility is now the apex hospital in the country; it caters for the welfare needs of even the first citizen in the country.

“So, we are poised to attend to such needs, and we have been doing that for quite a number of years.”

He, however, said that there had been changes that had adversely affected the mandate that was given to the hospital.

Raji said that some of them brought about challenges which included funding and supervision.

“As a result of these challenges, there has been some reduction in the ability of NHA to meet that exact mandate.

“Some of the equipment that was there before, that were world class equipment, has, over the years, not been changed.

“Some have gone bad and no more work. Some do work, but then I would say they are limping. So, as a result, it is not able to now efficiently give that primary mandate that it has been mandated to give. But this is what we are working on.

“The current leadership of the Ministry of Health is on top of their game, trying to set things back on track for NHA and other hospitals.

“In extension, the management of NHA is also working assiduously towards that to see that our previous mandate is really achieved.”

With regards to the funding needs of NHA, he said that the hospital, being a part of the society, also feels and is subjected to what other government institutions face.

According to him, lack of funding is something that has affected the whole facets of the Nigerian economy and the government over the years.

“I wouldn’t blame any particular administration because the economic hardship is something that all administrations have been working hard towards resolving, but the dwindling economy has affected NHA adversely.

“Previously, when NHA was first created, it happened to be under the presidency and bureaucracy was less, sources of funding and the volume of funding was much more, but as time went on, NHA was moved under some other segments of government.

“However, even those, like the ministry, are also not finding it funny in terms of funding.

“So, for them to even be able to fund hospitals through budgetary means or interventions, though they have tried as much as they can, they may not be able to go round all the tertiary hospitals in the country.

“We are talking about more than 70 tertiary institutions that are handled by the Federal Ministry of Health.

“So, however hard they try, which they are trying actually, they may not really go through each hospital as much as that hospital needs, so that’s how it has affected us.”

The CMD, however, said that to ameliorate the situation, some interventions had come through some organisations either through philanthropic gestures or Public Private Partnership (PPP).

He said that NHA had, over the years, gotten support from MTN and Airtel, while PENCOM has also built and equipped a certain segment of the hospital and donated other items to the hospital.

“There are so many others too numerous to mention. The National Agency for the Control of AIDS (NACA) has also contributed, and the Global Fund is also trying to do something.

“We have discovered that funding outside the statutory government budgetary provisions and PPP arrangements are also a way to go.

“So, since our arrival, we have really been going to various sister organisations, discussing, and interfacing with them, telling them our issues, seeing how we can collaborate and a number of them are coming on board.

“The Nigeria Customs Service has assisted us with vehicles. We are still trying to interact with a number of others now and we will keep doing that until we get what we want.

“Also, some organisations have approached us with regards to PPP arrangements, so in the next couple of months, we will see what this would yield.

“Already some PPP arrangements are working in our radiology section and our electronic medical records,” he added.

NAN reports that NHA was established by Act 36 of 1999, as a 200 bed National Hospital for Women and Children (NHWC), under the Presidency.

It was originally designed to cater for the needs of women and children in Nigeria and the West African sub-region, to reduce morbidity and mortality rate.

It was also expected to carry out extensive research into the peculiar causes of women and children-related diseases in Africa.

However, in 2000, the name was changed to National Hospital with a mandate to cater for all and in 2011, it was transferred from the Presidency to the Federal Ministry of Health.

The hospital has expanded to a 400-bed facility and now renders specialist services in all areas of medicine. (NAN)

Edited by Ifeyinwa Omowole

By Folasade Akpan

The Chief Medical Director, National Hospital, Abuja (NHA), Prof. Muhammad Raji, on Sunday said the hospital’s In Vitro Fertilisation (IVF) and Cancer centres had recorded huge successes over time.

Mahmud disclosed this in Abuja, while speaking with the News Agency of Nigeria (NAN).

According to him, NHA, which began IVF in 2006, is probably the first or one of the first government hospitals to have an IVF centre.

He added that it was also about the cheapest and had, over the years, brought joy to a number of families who had lost hope.

“It has been quite successful, and I must applaud the people running it; they do it quietly. They don’t make so much noise about it.

“The doctors, nurses, embryologists do so much. If you visit our IVF centre, that is when you will know what dedication is.

“You need to be there every second of the way. Once you start a cycle, until you finish, you have to be with your client closely from the beginning till the end.

“That really demands a lot of dedication and patience, and you never hear them complain. We are really proud of them,” he said.

For the cancer centre, he said that NHA boasts of some of the best equipment for the treatment of cancer making the hospital’s cancer centre about the best.

“We have two Linear Accelerator (LINAC) machines which is one of the high-end radiotherapy treatment machines.

“We have a brachytherapy machine which can be used in the treatment of some enclosed cancers like cancer of the cervix and prostate cancers.

“We also have a nuclear medicine department.

“Nuclear medicine treats things like goitres and cancers of the thyroid gland and in other parts of the body.

“Beside chemotherapy, the hospital also engages in surgical oncology, so we have a holistic approach to cancer treatment.”

He explained that some centres carry out surgery to just treat the cancer, while patients were referred to another centre for chemotherapy.

“In some cases, if the patient does surgery in one centre, he or she has chemotherapy at that centre while radiation therapy and other things would have to be done elsewhere.

“But here, we have everything available, and we have also trained so many for the country.

“The International Atomic Energy Agency (IAEA) has identified NHA as a very sound partner, so we work closely with them through the Nigeria Atomic Energy Commission.

“Now that the National Institute for Cancer Research and Treatment (NICRAT) has also been created, we have started working closely with them.

“So, we have treated thousands of patients with cancer.

“A number of them have been treated to cure, some that are advanced have been treated palliatively to make their lives better till God determines.

“We have never pushed away a case of cancer and we lose so much money because before a patient comes to NHA in terms of cancer, he must have tried so many other places.

“Some have tried herbalists and even when they go to hospitals, it is not all doctors or facilities that can immediately detect cancer.

“So, by the time a patient eventually comes to us, he or she must have expended a lot of money.”

He further explained that cancer and trauma were two things that could run a whole extended family into poverty because of how expensive they could be in terms of treatment.

He added that once they come to the hospital, they try to treat them as much as possible and once they commence treatment, especially chemotherapy, they never drop them.

“Some patients are unable to pay but the hospital just finds a way of subsidising it for them to go through it,” he said. (NAN)

Edited by Abiemwense Moru/Ephraims Sheyin