Community Health Insurance Scheme Solution To Maternal Mortality In Nigeria
Every single day,UNICEF says Nigeria loses about 2,300 under-five year olds and 145 women of childbearing age. This makes the country the second largest contributor to the under–five and maternal mortality rate in the world.
Although analyses of recent trends show that the country is making progress in cutting down infant and under-five mortality rates, the pace still remains too slow to achieve the Sustainable Development Goals of reducing child mortality by 2030.
Stakeholders in the health sector however are of the opinion that this trend could be further reduced through Community Based Social Health Insurance.
In this special report Modupe Aduloju weighs the option of the Scheme and the impact its likely to make at the grassroots
According to the UNICEF report, deaths of newborn babies in Nigeria represent a quarter of the total number of global deaths of children under-five.
The majority of these occur within the first week of life, mainly due to complications during pregnancy and delivery reflecting the intimate link between newborn survival and the quality of maternal care.
While Main causes of neonatal deaths are birth complications, severe infection, including tetanus and premature birth.
In 2015, life expectancy in Nigeria was around 53 and 56 years for men and women respectively, while Nigeria constitutes only about 2 percent to the world population and it contributes up to 10 percent to maternal mortality in the world.
Almost all maternal deaths can be prevented, as evidenced by the huge disparities found between the richest and poorest countries. The lifetime risk of maternal death in high-income countries is 1 in over 3,000, compared to 1 in 41 deaths in low-income countries.
Community Based Social Health Insurance , is targeted at people within the informal sector, people who do not work with government and organisations so that they can have health insurance coverage.”
The Programme Communication Person, Christian Aid,,Ms Nneoma Anieto, explains CBSHI can be for a cohesive group of households/individuals or occupation-based groups.
The Consultant on Policy, Budget Work and Legislative Advocacy, Development, Research and Policy Center, Dr. AREMU, Fatai said there was need for synergy between maternal , child health and community based insurance scheme.
Karava is a community of two hundred and fifty people,in Bwari Area council,few kilometers from Nigerian Law School, apart from poor access road,non availability of school for the community.
The women use self help services during delivery of their babies as explained by Felicia Dikko in Gwagyi a member of the community.
The women gave birth in their homes without visiting the healthcare centre.
The, Public Health Advisor for Nigeria Health Watch,Dr Ifeanyi Nsofor said there was need for states and local governments to domesticate health insurance scheme for the benefit of people in communities.’
“CBHIS is a type of health insurance scheme under the informal programme of National Health Insurance Scheme, NHIS. It is targeted at people within the informal sector, people who do not work with government and organisations so that they can have health insurance coverage.”
The minister of Health Professor Isaac Adewole agreed that the country has one of the worst maternal mortality figures in the world.
“The maternal mortality rate in Nigeria is 560 deaths per 100,000 live births and one-third of all global maternal deaths are concentrated in two populous countries which includes Nigeria, after India.” India, with 50000 deaths ranks first whereas Nigeria takes second place with 40000 estimated deaths.”he said.
The minister said the establishment of the National Health Insurance Scheme (NHIS) was a major highpoint and output of the reform policy and an avenue to work towards the attainment of Universal Health Coverage (UHC) in the country
Professor Adewole said to achieve the desired result there was need for all Nigerians to contribute towards the scheme
On her part,Dr Dorothy Nnamani, an Executive Director of one of the Health Maintenance Organisation in Nigeria, said communities can come together to form a scheme.
“A minimum of 500 persons is required to form a user group. Households have the option of paying in convenient installments or one flat rate for the care package. Benefits are restricted to those services obtainable in a primary health care facility.”she added.