As part of on-going national health reforms aimed at reducing Out of Pocket Expenditure (OOPE), HSCL in collaboration with Results for Development(R4D) is providing technical assistance to the governments of Kaduna and Niger states for the design and implementation of pro-poor social health insurance schemes. This is through the BMGF funded Demand Side Financing (DSF) project, aimed at improving access to quality primary health care services and reducing out-of-pocket payments with emphasis on pregnant women, children, and those living in poverty. The project commenced in 2017 and has recorded major milestones including those below:
Design of the State Contributory Schemes
HSCL and R4D supported the states through a design process that reviewed the different options, their implementation requirements, and critical success factors. This approach helped the states adapt the scheme designs to best suit their population needs and economic realities. The design components include population targeting, enrollment, benefit package determination, premium determination, pooling and fund management arrangements, provider engagement and payment mechanisms, and quality assurance, amongst others.
Costing and Finalization of Benefit Packages
Through the DSF project, the consortium supported the states to cost their proposed benefit packages and through actuarial studies, determine premiums. The consortium further guided the states to properly align the benefit packages of their schemes with the Basic Health Care Provision Fund (BHCPF) recommended package, to improve efficiencies during implementation.
Development of Key Operational Documents
In Kaduna and Niger States, the consortium provided support to the State Contributory Health Management Authorities on the development of health care provider service level agreements, drugs and service tariffs, and operational guidelines.
Empanelment of Providers and Enrollment of Beneficiaries
The project has been providing technical assistance to the Kaduna and Niger contributory health agencies for the empanelment of public and private facilities and enrollment of beneficiaries. Specific support areas include the development of facility assessment and accreditation tools, population targeting strategies, selection and deployment of ICT platforms, and community sensitization. By March 2020, Kaduna State had enrolled 114,607 beneficiaries while Niger State is to commence enrollment in July 2020.
Capacity Building for Authority/Agency staff
The consortium has continued to strengthen the capacity of the health insurance coordinating agencies and other affiliated agencies in Kaduna and Niger States. Besides didactic trainings on the different aspects of the implementation of the health insurance, the agencies receive hands-on support and mentoring from the in-state HSCL teams.
“Through the technical mentoring of R4D and HSCL, the Niger State Contributory Health Agency (NGSCHA) has developed a database for the vulnerable population to align with BHCPF program of the Federal government.”
Director, Providers Management and Benefit Package,
Niger State Contributory Health Agency (NGSCHA)