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A WEEK OF HEALTHCARE AND OTHER MATTERS

Quite another busy week the foregoing; and an even busier one promises to be around the corner. So, altogether, ma sha Allah.

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Anyone who listens to the radio in Kano cannot miss the incessant appeals for assistance from patients suffering from one ailment or another, and for which hospitals are asking for money to treat. The poor from Kano and many neighbouring states converge on Kano to launch their pitiable, pathetic appeals on programmes such as Taskar Labarai, In Da Ranka and Ku Karkade Kunnuwa…, etc.

One would hear every night appeals such as “I have been suffering from Tumour A or Cancer B for many years…I have been to Hospital XYZ and they are asking for N900,000 for the operation. Please help me.” Makes one wonder where is Government, and what serivces do the hospitals really offer.

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That is why I was impressed this week when the Kano State Medical Students Association (KAMSA) had as its Annual Lecture the theme “Implementation of Kano State Contributory Healthcare Scheme”, delivered by Executive Secretary,  Kano State Contributory Healthcare Management Agency (KSCHMA) Dr. Halima Muhammad Mijinyawa (halimamijinyawa@yahoo.com). The Agency is Kano’s unique alternative innovation as the word “Insurance” contained in the Federal Government’s National Health Insurance Scheme (NHIS) was adjudged non-Islamic-compliant by our ever-vigilant Ulama. 

The KAMSA, as it does every year, combines the Annual Lecture with presentation of its annual Journal which, this year was as usual well designed and pleasing to the eye. Edited by a group led by our daughter Na’ima Ibrahim (ibrahimnaima@ymail.com), Level 500 BUK/AKTH medical student, the publication contained articles on Depression; Monkey Pox; Cosmetic Dentistry; Health Benefits of Moringa Oleifera or Zogale (even doctors are coming round to it); Happiness; and a Special Interview with Dr. Amina El-Yakub, first female general surgeon of Kano State extraction. Kudos to KAMSA Editorial Team for dabbling out of medicine and into my area of journalism!

In the ususal utilitarian tradition of this Column, your correspondent was Discussant at the event, and I spoke on behalf of you, the Patients. It is the hope of this Column that those poor souls crying away their nights on the radio stations could be enrolled onto this scheme by Government or some Good Samaritan.

The following are excerpts from Dr. Halima’s paper:

Healthcare delivery in Nigeria is characterised by poor health indices as a result of inadequate funding, poor infrastructure, inadequate manpower, lack of equipment as well as poor community participation. The process of creating KSCHMA emanated from the proposal of the NHIS to give state governments power to create organisations that will manage their unique Contributory Healthcare Programmes to facilitate achieving Universal Health Coverage.

KSCHMA was established in August 2016 with the responsibility of managing Kano’s version of the scheme. Its function is simply to promote, regulate, supervise and ensure effective implementation of the scheme, a system of advance financing of health expenditure through contributions, donations or taxes paid into a common pool to pay for all or part of health services specified by the benefits package.

Objectives of the scheme include to: ensure all residents of the state have access to effective, quality and affordable healthcare; protect families from financial hardship of huge medical bills; limit inflationary rise in the cost of healthcare; ensure equitable distribution of healthcare costs across different income groups; maintain high standard of healthcare delivery within the health sector; improve and harness private sector participation in the provision of healthcare and efficiency in healthcare delivery; ensure adequate improvement of health facilities within the state; ensure appropriate patronage at all levels of healthcare delivery; and ensuring availability of alternate sources of funding to the health sector for improved services.

Designed programmes are either formal or informal. The formal include; Public Sector Employees (State and Local Governments), Organised Private Sector (OPS) for organisations with a minimum of five members of staff; Tertiary Institutions Contributory Healthcare Scheme (TICHS); Uniformed Servicemen and Retirees. The informal include Vital Contributors (individuals not in any contributory programme), Community Health Programmes (for, say, an entire village), and Vulnerable Group Healthcare Programme (for, say, Persons with Sickle Cell Anaemia). 

Contributions to the scheme vary. For the OPS, employer contributes 10% while employee chips in 5% (representing 15% of the employee’s basic salary). Students of tertiary institutions pay N2,000 per session while retirees’ contribution shall be determined by the agency after due consultation. Vital Contributors shall pay N12,000.00 per annum per person, while a 10% discount is applicable to a family of six or a group of six people and above. The scope of the programme covers an employee, a spouse and four (4) biological children below the age of 18 years. Principals are entitled to register a maximum of four (4) additional dependants (wives, parents, and biological children below the age of 18 years), upon payment of N9000/per person per annum.

The agency shall bear the cost of registration of enrollees and production of initial enrollee identity card(s); beneficiaries can freely choose their accredited primary healthcare provider and can receive treatment at the nearest registered healthcare facility on emergency; enrollees are entitled to 21 cumulative days per annum hospitalisation and, in cases of orthopaedics, entitled to hospitalisation for six cumulative weeks. The cost shall be borne by the agency. 

Major challenges faced include labour unions’ refusal to accept three months waiting period, and the challenge of referral systems. All in all, this effort of setting up this scheme is very commendable as it will significantly contribute in strengthening the health system in the state by providing additional sources of funds and also in job creation. Allah dai Ya sauwake!

THE DAPCHI DUPLICITY: Believe this you will believe anything! No head has as yet rolled on Dapchi, but the greatest revelation was ‘our security forces executed a tactical withdrawal to allow Boko Haram RETURN the abducted children’. Interesting! Did they also execute similar tactic BEFORE abduction? No ransom paid? No prisoner swap? Haba! Say WALLAHI! Our sympathies go to the families of the five girls who died unncecessarily, and of the last girl still held. Going forward, these successful ‘negotiations’ should ALWAYS take place BEFORE abduction to save us lots of embarassmant and heartache.

‘DA RUWANA’ SUMMIT: Starting tomorrow Sunday and into Monday at FABS Centre in Kano, a leading Kano NGO, Kano LEADS (led by that indefatigable daughter of Kano Aisha Dankani, retired Federal civil servant and businesswoman), is convening a Roundtable tagged ‘DA RUWANA’ (‘It Concerns Me’) to discuss socio-economic problems afflicting Kano and the Greater North – and many are they. The Roundtable aims at ‘highlighting our challenges as well as proferring practical solutions…’

“JUYIN SARAUTA” PRESENTATION: Come Tuesday 27th March, a Hausa cultural movie titled ‘Juyin Sarauta’ (or ‘Palace Coup’), produced by Hajiya Balaraba Ramat Yakubu (author of ‘Alhaki Kuikuyo’ etc, and small sister of late General Murtala) will be presented in Kano. The film is about Hausa people, culture and tradition. Resplendant pageantry, beautiful scenes, knotty royal intrigues – lead role well acted by famous author Ado Gidan Dabino; well directed by Falalu Dorayi.

TSA, PICA, WHISTLE: This week, I spoke at ‘Seminar for Media Correspondents Covering Federal Ministry of Finance’ in Abuja. Organised by senior colleague (at BUK and BBC) Salisu Na’inna Dambatta, Director Information at the Ministry, the Seminar opened many an eye on Government’s Treasury Single Account (TSA), Presidential Initiative on Continuous Audit (PICA), Islamic SUKUK, and Whistle Blowing. One important takeaway – a certain woman blew the whistle on her thieving husband – after enjoying the loot with him for long. Reason? Turned out he was planning to take another wife, so…Firrrr!!! She blew game over! Firrr! Wasa ya tashi! Firrr!

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