Universal Healthcare Coverage: The Role of the Private Sector - Dr. Richardson Ajayi
The Nigerian Health Insurance Scheme (NHIS) was launched in 2005 with the vision of achieving universal healthcare coverage for all Nigerians. Universal health coverage has the objective of providing access to healthcare, protecting people from financial hardship, and delivering improved outcomes. These objectives have mainly not been achieved with most Nigerians still paying for healthcare out of pocket and having no protection from catastrophic financial loss as a result of health expenditures. There is a debate about the percentage of Nigerians having access to health insurance, but Prof. Usman, the NHIS Executive Secretary, believes the number is probably less than 1%. Whatever the actual figure, the vast majority of Nigerians still do not have access to healthcare without financial hardship.
A W.H.O study of member countries shows that the Nigerian health system ranks 187 out of 191 member countries, which reflects the poor health outcomes seen in Nigeria compared to other countries. For example, the average life expectancy of 54.4 years in Nigeria is low when compared to 63.9 years in Ghana, 63.8 years in South Africa, and 81.2 years in the United Kingdom. Similarly, the child mortality rate in Nigeria of 109 out of 1,000 live births is high compared to 62 in Ghana, 41 in South Africa, and 4 in the United Kingdom. 814 out of 100,000 women die in childbirth in Nigeria, compared to 319 in Ghana, 138 in South Africa and 9 in the United Kingdom. There is much work to do towards achieving universal healthcare in Nigeria.
The purpose of this article is to explore the role of the private sector in driving the development of universal healthcare in Nigeria. The private sector is a significant contributor to healthcare delivery in Nigeria. A study by Ernst & Young shows that 73% of the total healthcare spend in Nigeria is driven by the private sector. The question, therefore, is 'what could be done to accelerate the development of universal healthcare by the private sector?' We can evaluate the issue with a focus on the three objectives of universal health coverage; access to care, financial protection, and improved healthcare outcomes.
Healthcare is a growing sector in the world economy. Developing countries like Nigeria should provide significant opportunities for investors to focus on strengthening both the demand side of healthcare as well as the supply side. The demand side in terms of health insurance and the supply side in terms of healthcare services.
There are significant opportunities to invest in primary care clinics. 80% of healthcare needs can be delivered within an out-patient basis. There is an opportunity to build chains of clinics and to focus on primary care. These chains can increase access to care and lower the overall cost of care if they are designed to run efficient financial models that focus on being asset-light. Similarly, there is a need for safe, low-cost mother and child centers to meet the needs of a growing population.
Health insurance is about risk pooling, and the current fragmentation of the health insurance industry compromises the needs of consumers. Present providers compete on price without significant value differentiation. There is an opportunity to consolidate the market, thereby establishing scale that can drive efficiencies within service provision. There are also opportunities to create enabling technological innovations that will increase access to care both for the already platforms that connect consumers as well as opportunities to use mobile technology such as Unstructured Supplementary Service Data (USSD) to expand access to the currently unserved.
There are also opportunities for private organisations to partner with government hospitals to share best practices through knowledge transfer arrangements. I believe it makes sense for government hospitals to explore possibilities to outsource such services as pathology services, management of the business, and measuring and tracking of key performance indicators. There should be increased participation of private sector business people on government hospital boards to improve the efficiency and performance of the establishment.
Health insurance is about financial risk pooling to provide access to care. It is in the interest of health insurance businesses to pay medical providers much lower rates than the premiums they receive to increase their profitability. This approach leads to increased commoditisation of healthcare in a bid to gain market share. Commoditisation is a real threat to healthcare outcomes.
The medical fraternity needs to unite with a singular voice and engage the health insurance industry to negotiate tariffs that will drive improvement in healthcare outcomes. The current trend to pay as little as possible for healthcare delivery hampers the development of the healthcare sector and should be resisted. More suitable tariffs will create win-win scenarios for the health insurance industry, medical practitioners, and drive improved patient outcomes.
Bridge Clinic Wins the NHEA’s for the Fourth Time since 2015
Bridge Clinic Fertiliy Centre bagged yet another glorious win as IVF Service Provider of the Year at the Nigerian Health Excellence Awards held on Friday, 21st June 2019 at Eko Convention Centre in Victoria Island, Lagos State.
The category had 4 nominees with Nigeria’s most fertile fertility centre, Bridge Clinic, blazing the trail as the one clinic trusted all round by clients, partners and staff for consistently providing excellent services and constantly raising the bar in the IVF industry.
Over the past 20 years, Bridge Clinic has been committed to setting the standards for quality healthcare delivery in Nigeria. Its success has been made possible by its committed team of consultant gynaecologists, fertility experts, medical officers and nurses, supported by an adept team of embryologists in and outside Nigeria. Its strict quality management systems audited annually by renowned firm, Quality Austria, also sets Bridge Clinic apart within the IVF industry.
All these have helped to define Bridge Clinic Fertility Centre as the acclaimed and irrefutable brand of choice for IVF and fertility management in every regard. Little wonder that it has clinched this award four times in 2015, 2016, 2018 and 2019.
Alexander Forbes verifies Bridge Clinic’s 2017 birth records
As proud pioneers of fertility services in Nigeria since 1999 and known for upholding ethical practice and setting the standard within the industry, Bridge Clinic has successfully undergone a validation audit of its birth records for the year 2017. This exercise was conducted by the international auditing firm, Alexander Forbes Consulting Actuaries Nigeria Limited.
The period under review spanned January to December 2017 and comprised analysis of In-vitro fertilization (IVF) treatments and birth records across the four (4) centres of Bridge Clinic; Lagos, Abuja, Port Harcourt and our partnership with LASUTH, The Institute of Fertility Medicine (IFM).
Summary of Outcomes
The audit revealed a 14% increase in pregnancy rates in comparison with the year 2016. Within the period under review, 27% of clients who presented at the clinic for their own IVF cycle were less than 35years. Gold standard clients are identified using the following parameters;
Over a 10-year period, Bridge Clinic has continuously strived to keep up with technological and procedural advancements in fertility medicine to provide clients with the best chance at success possible. This effort peaked in 2015 where the clinic achieved the highest clinical pregnancy rate at 49% and steadily maintained success rates within the upper 40’s.
Several parameters with respect to birth rates were also measured with a steady rise in clinical pregnancy rates from 24% in 2015 to 30% in 2017. Live birth rates also rose in comparison to 2016 from 25% to 28%.
This result when distilled showed a high number of singleton and twin gestations with over 170 births in 2017.
According to Alexander Forbes, the methods and assumptions deployed during Bridge Clinic's audit "satisfy the requirements of treatment procedures and expected outcome and taken as a whole, are mutually compatible."
This audit has further consolidated Bridge Clinic as Nigeria's Most Fertile Fertility Centre consistently delivering on her promise to be transparent with a verified birth count of well over 200 babies and counting in 2017 alone. Hence, earning the trust of clients, medical practitioners and partners across Nigeria and beyond its shores.
The exercise was concluded and the report signed off by all parties on 28th March 2019.
Quality Austria 2019 re-surveillance audit of ISO 9001:2015 certification
In accordance to our commitment to Quality, we have completed our annual audit for 2019 (Re-surveillance audit); having reviewed all our internal processes and systems by our External auditors- Quality Austria, we are proud to announce that we again have demonstrated that we have full understanding and achieved compliance with the requirements of ISO 9001:2015. This is a continued assurance of the value proposition to our patients which results in
A big congratulations again to the entire team
NHEA Awards Bridge Clinic Fertility Centre ‘IVF Service Provider Of The Year’
Bridge Clinic Fertility Centres was awarded the highest honour at this year’s Nigerian Healthcare Excellence Awards (NHEA). We are honoured to have won the IVF Service Provider of the Year award, which celebrates excellence and quality in healthcare service delivery.
Bridge Clinic was also recognised as IVF Service Provider of the Year in 2015 and 2016.
The Nigerian Healthcare Excellence Award (NHEA) is an annual event which celebrates distinguished personalities and organisations who have contributed immensely to the growth of the Nigerian health sector.
NHEA is an initiative of Global Health Project and Resources in Partnership with Anadach group. Started in 2014, it has since become a high profile event in the healthcare industry, gaining wide acceptance from stakeholders in the healthcare community, public and private sectors.
NHEA’s recognition aims to stimulate quality improvement and innovation in the Nigerian health sector leading to improved service delivery & management of key health issues and the capacity of individuals to influence and set new performance standards in Nigeria & beyond.
The award evening took place at the Eko Hotel and Suites on Friday, 22 June 2018. For more information, click here to visit the NHEA website
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