By Mohammed Aminu
The FCT administration (FCTA), in 2006, set up an independent project named FCT Health Services Scheme (FHSS) to handle health insurance in the FCT. It was a welcome development. Following this, residents of the FCT had high hopes they would benefit much from the scheme. I chose to be taciturn or entirely mute over it until now. A shocking and startling revelation about a plot to cripple health in the FCT has provided a rich insight into the cause of the setback being suffered by the scheme as witnessed in its abysmal performance. The cause is not far-fetched. Rather than concentrating attention on effective implementation of the scheme, efforts, attention and intellect are now being diverted to controversy, rivalry and confusion which have set in to derail the scheme and its key personnel.
It has been observed, however, that the scheme is far from meeting people’s expectations in the FCT. This is made clearer when one visits a hospital and observes some poor Nigerians who languish in the hospital because of inability to pay hospital bills. Some women in the villages have rather taken to the option of delivering their babies in the hands of native midwives because of fear that they would become doctors’ property by barter for unpaid bills. There is no need, of course, to say that child-birth in the hands of traditional nurses is not acceptable in this century as complications, bleeding and other forms of side effects take the place of jubilation after such birth.
According to a newspaper report, the FHSS was created by the resolution of 12th FCT Executive Committee meeting, of April 4, 2006 and was set under the supervision of the Health and Human Services Secretariat (HHSS) of the FCT administration (FCTA). Later all, a parallel scheme was created purportedly under the office of the FCT minister of state called FCT Area Council Health Insurance Scheme and Community-based Health Insurance Scheme (FACHIS/CBHIS) which was headed by Dr. Grace Aganaba, a former project coordinator of FHSS. That followed the redeployment of Aganaba to the FCT Primary Healthcare Development Board (FPHCDB) and her refusal to be moved.
However, what was not clear was which resolution set up the FACHIS and its CBHIS. However, according to the report, Aganaba claimed to have an extract to the effect of the creation of FACHIS/CBHIS. Whichever side of the argument is plausible, there is the need for the FCTA to look into the issues raised and harmonise the operation of the scheme. This urgently needed to be done.
In the course of doing this, there is the need to seek answers to pertinent questions surrounding the disparity in the charges between the two schemes. If the FHSS/CBHIS charges N1,500 per household (a man, his wife and four children) annually as approved by the supervisory authority, how can Aganaba-led FACHIS/CBHIS charge as much as N1,800 per head. The question that follows this disparity is: “Is it the same FCT authority that set the higher charge in the same scheme for area council staff and rural community members?” Again, what criterion could suffice in explaining the inconsistency and divergence which result in area council staff and rural dwellers with lower income paying higher than FCTA staff?
It is also necessary for the FCT administration to consider the expression of dissatisfaction by subscribers to the scheme. Urgent decisive steps should be taken in addressing such dissatisfaction as a way of restoring people’s confidence in the scheme. This will not only keep the scheme in the right course and ensure efficiency but also attract largesse from non-governmental organisations (NGOs) to the scheme.
Similarly, with Health Maintenance Organisations (HMOs) assigned to work with the scheme in management of funds generated for its operation, the essence of assigning the HMOs can only be justified when the needed pool of funds is available for them to manage through popular participation in the project. Efforts should also be made to cover more FCT communities in the scheme.
There must be standard policy to guide administration of funds by the HMOs; this will guide against double-dealing HMOs between an officially established scheme and any other unofficial scheme. The needed fund to be pooled from minute contributions from subscribers to keep the scheme working will come from rural dwellers where the bulk of the population may be. Reviving health insurance scheme in the FCT is one thing that needed to be done if it must operate effectively in the FCT and its communities. Interestingly, it will be a way of improving and transforming the wellbeing and healthcare of Nigerians in the FCT in line with President Goodluck Jonathan’s transformation agenda. It’s time to end this rivalry and get focused.
Mohammed Aminu wrote in from Gwarimpa, Abuja.