UNIVERSAL HEALTH COVERAGE: A FLASHBACK TO KWARA MODEL

Date: 2017-08-21

...Fatigun is a former Chairman of Ekiti LGA in Kwara State. In the era of boom, quality healthcare for those in the informal sector was terrible. With the nationwide recession, it is much worse. The thought of how to overcome the difficulty and provide for the masses gave birth to the Kwara Health Insurance Scheme, initiated over a decade ago by Dr. Abubakar Bukola Saraki as governor of Kwara State in 2007.

It is fitting that Saraki now President of the Nigerian Senate, will blaze the trail in the introduction of a Health Insurance Scheme to Nigeria. A medical doctor, whose father, Abubakar Olusola Saraki, was also a medical doctor, with a long history of having compassion for the masses, the younger Saraki inherited this trait.

Therefore, concerned about the health challenges of Kwarans, especially those in the informal sector, and their lack of access to quality and affordable healthcare, Saraki's first programme shortly after he was sworn in as the Governor of Kwara State in 2003 was the introduction of the Kwara Health Insurance Scheme. The scheme has continued to benefit thousands of Kwarans. As Senate President, Saraki recently canvassed for the introduction of a similar scheme for those in the informal sector across the country. While receiving World Health Organisation (WHO) Regional Director for Africa, Dr. Matshidiso Rebecca Moeti, who was accompanied by the Hon. Minister of Health, Prof. Isaac Adewole, Minister of State for Health, Dr. Osagie Ehanire, and other top management staff of the Federal Ministry of Health, Saraki said that one of the strategies to achieve Universal Health coverage was to provide a health insurance scheme to the informal sector of the country.

"The Universal Health Coverage is something that is dear to my heart. I remember when I was Governor of Kwara State, I introduced informal health insurance scheme to those who are unemployed in rural areas as I have always believed that the formal sector can take care of itself", he said. What Saraki, a modest man who rarely sings his own praise, did not tell his audience was that when he became the Governor of Kwara State, he inherited a healthcare system that was worst than hospitals being mere consultancy centres.

Kwarans died in thousands because they could not afford the cost of medical care which made them resort to herbs and traditional healing, which in turn caused more damage instead. Working with local and international partners like the Dutch Government, The Health Insurance Fund, Hygeia Community Health, PharmAccess Foundation and others, Saraki started the pilot project in one of the 16 local government areas in the state.

Upon payment of N200, then in 2003, every individual was entitled to medical treatment for the rest of a financial year. Beneficiaries enjoyed free consultation, supply of drugs, medical investigation, blood transfusion, ultra sound scan and minor surgeries such as Caesarian Section, appendectomy, circumcision, evacuations and others.

The insurance scheme also covers maternal and child care, chronic diseases, hypertension and diabetes, minor surgeries such as caesarean section, hernia, circumcision, appendectomy, evacuation surgeries as well as the treatment of lifestyle and some non-communicable diseases and other primary healthcare activities.

The then state government also designed a scheme that worked through community leaders. There is a Board of Trustees for each community, usually headed by the traditional ruler. The board mobilised the community for participation and manage the scheme for optimum performance.

In Edu local government, where the pilot project took off, the scheme enjoyed tremendous patronage. The General Hospital in Tsonga that previously hardly attended to 10 patients in a day had over 5000 patients in the first month. Nearly everyone in the town, from the traditional ruler to the peasant farmer, registered for the scheme.

Buoyed by the success of the pilot scheme, Saraki expanded to other local government areas in the state before he handed over to the current governor, Abdulfatah Ahmed, in 2011. The scheme had covered 10 out of the 16 local government areas with 400 communities. Within the same period, over 3,000 births and more than 600 caesarean sections were carried out. The scheme was limited to rural areas because Saraki was concerned about how to subsidise healthcare and make it affordable for those living on one dollar and below per day.

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