Saifullahi Attahir Wurno
Last week, in the clinic with my Consultant lecturer at Rasheed shekoni Teaching Hospital, we came across a woman 35 years of age who came from Gumel, she had recurrent anaemia that required her to be transfused with blood almost twice a month. This time she presented with complaint of yellowish eyes, fatigue, and occasional abdominal pain. After a brief examination the Dr. requested some blood tests for her after which she came back an hour later.
From the result the Dr. told her that the most likely cause of her condition was a liver problem that reduce the protein in her system making her prone to anaemia. Upon that, he prescribed some drugs for the her, surprisingly, she broke down into tears crying incessantly. Noticing that, the Dr. began to console her thinking it was the ailment that causes the grief.
The woman explains that she was a divorcee currently living alone as a result of some misunderstanding with her spouse that has root to the ailment. In the previous year, her ailment put her in hospital where the Doctors found a precancerous lesion in her liver that requires treatment, the unaffordable medical bills arrived.
She had to sell her livestocks, and eventually her farm. Having exhausted all her savings and belongings in search of cure ranging from General hospital and now at Shekoni. On that day, She got a loan of 6000 which she used for the transport and the lab test, barely the change can get her back home.
From the above story ,this is the typical condition of people living in Jigawa state whom are majority subsistent farmers and traders that can not afford most of the costly health care expenses.
But here is a good news, It’s quite a congratulatory note that the Jigawa state government have decided to expand it’s wings of previous Health insurance Scheme (Jigawa State Contributory Health Management Agency, JICHMA) aimed to provide universal health coverage (UHC) by including the non formal sector that constitute more than 95% of the state population.
The JICHMA was established in 2019 and since then lead by Dr Nura Ibrahim. It’s under his able leadership that the Agency saw to the successful health insurance coverage of more than 90% of the state and local government civil servants.
As part of the Federal Government initiative to address the challenge of the huge out of pocket (OOP) health financing and to bridge the gap in the inequity accessing qualitative healthcare, the National Health insurance scheme (NHIS) became fully functional in 2005.
But over almost two decades, the Scheme only covered 5% of the population with over 70% of the house hold spending on healthcare coming from individual pockets which is inadequate and unsustainable. Hence the Federal Government came up with the healthcare trustfund in 2021 to include the less privileged and vulnerable groups in the society to benefit too.
Due to the lessons drawn from the struggled National system, the able Governor H.E Umar Namadi as a former staff of the NHIS, the Jigawa State Government collaborated with an indigenous and refutable person Mallam Aminu Bizi through his Bizi Cashless consultancy Firm to strategize an effective platform that would ensure the enrollment of the informal sector to benefit in the attainment of Universal health coverage.
The Scheme is financed through a PPP (public private partnership) where by any individual can register through the Bizi consultancy Firm at a very affordable fixed amount monthly contributory payment and automatically get enrolled in to it either alone or along with his family members.
This is an applaudable effort by both the Government and the Consultancy Firm, as we witness the increased difficulty incurred by the majority of the state population who can not access a descent and affordable healthcare services just because of poverty.
As a tripartite system involving the Jigawa Government, the Health management organization (HMO), and the Health care providers (Hospitals), the scheme had previously met setbacks that upon hinder the attainment of its intended purpose. The obstacles includes; very low level of awareness, abject poverty by the masses to pay for the meagre contributory part, drug out of stock in the hospitals, and weak monitoring and evaluation.
I hope the Government through the JICHMA Management and the Bizi Firm would ensure the success of this initiative through persistent public awareness by sponsoring Radio, television, social media jingles and door-to-door advocacy campaign. The Agency should add more effort in tackling the issue of out of stock essential drugs that many enrollees complained of.
Saifullahi Attahir Wurno, is a Medical Student of Federal University Dutse.
[email protected]