INTRODUCTION:

The Basic Healthcare Provision Fund (BHCPF) was established by section 11 of the National Health Act, 2014. Its overall aim is to move Nigeria towards achieving Universal Health Coverage (UHC) which is a strategic development goal as contained in the National Strategic Health Development Plan (2018-2022).

Funding of the BHCPF would be derived, as stipulated by the NHAct, 2014, from (1) an annual grant from the Federal Government of Nigeria of not less than one percent (1%) of its Consolidated Revenue Fund (CRF); (b) grants by international donor partners (c) funds from other sources either public or private sector(s), and 25% State counterpart funding.

The purpose of the BHCPF is threefold: 1) Ensuring the provision of a Basic Minimum Package of Health Services (BMPHS) to all Nigerians, by applying 50% of the funds towards purchase of the BMPHS to be managed by the National  Health Insurance Scheme (NHIS). 2) Strengthening the Primary Healthcare System (PHC) system-with 45% of the funds-to be managed by the National Primary Healthcare Development Agency (NPHCDA); and 3) Providing Emergency Medical Treatment (EMT) with 5% of the BHCPF to be administered by the National Emergency Medical Treatment Committee (NEMTC).

The National Health Act, 2014 recognizes the Primary Healthcare (PHC) as the foundation and basis for the provision of healthcare services in Nigeria. In line with this, the BHCPF would be directed towards achieving at least one fully functional primary healthcare centre in every political ward of the Federation.

The NHIS Gateway of the BHCPF operates via transmission of funds in the form of premium for lives covered from the NHIS through the state social health insurance agencies to the healthcare providers.

States are required to contribute 25% of NHIS disbursed funds as counterpart funding. This can be drawn from the Equity Funds of the State Social Health Insurance Scheme. The cost of the BMPHS was actuarially determined at N12,000 (Twelve Thousand Naira) per life per annum. Payments for services rendered at the PHC level would be by capitation while that for secondary care would be based on fee-for-service.

KEBBI STATE BHCPF IMPLEMENTATION WORKPLAN

The implementation of BHCPF in Kebbi State started concurrently with the establishment of a state social health insurance agency and scheme. Mostly, the State leveraged on the intervention of the Federal Ministry of Health, NHIS, and partners to facilitate achievement of a viable state social health insurance agency backed by law, that has the capacity to implement not only state health insurance scheme but also the BHCPF program.

The strategic Goal of BHCPF implementation in Kebbi State is to ensure that the vulnerable population have access to quality Basic Minimum Package of Health Services (BMPHS) at the PHCs through a social health insurance programme administered by a competent KBSHIA.

The strategic Pillars are four:-

1. Strengthening of KBSHIA for the implementation of BHCPF in Kebbi State.
2. Provision of ICT Management System for the implementation of BHCPF.
3. Prompt transfer of capitation payments to accounts of participating PHCs and Fee-for-Service to Secondary Healthcare Providers.
4. Conduct of regular Quality Assurance visits and Monitoring and Evaluation exercises.

ENROLMENT STATUS

The Kebbi State Contributory Healthcare Management Agency (KECHEMA) has successfully completed the enrolment of all the 39,936 lives on 24^th August, 2022 and beneficiaries have since been accessing services.

 

KECHEMA involved important stakeholders in the enrolment exercise: State NHIS Office, SOCU (NASSCO), NBS, CAC, Kebbi State House of Assembly, Chairmen of Local Government Councils, Politicians, Religious and Traditional leaders etc. the critical role played by the four Emirate councils in the State cannot be overemphasized. The Chairman State council of Chiefs, HRH Major gen. Muhammad Iliyasu Bashar (OFR, CFR, mni) and the Emir of Argungu Alh. Sama’ila Muhammad Mera (CON) did not only assist in identifying genuine beneficiaries of BHCPF but also paid premium for hundreds of other vulnerable persons to enroll into the informal sector programme of the Kebbi State Contributory Healthcare Scheme (KECHES).

The National Bureau of Statistics (NBS)  Kebbi State Office availed KECHEMA with the latest population estimates of the State and all the 21 LGAs. That made it easier for KECHEMA to allocate the number of beneficiaries equitably amongst the LGAs. Some stakeholders were however, reluctant to bring the number of would-be-beneficiaries allocated to them. The numbers were re-allocated to others that would respect the deadline for enrollment execrcise.

The NHIS Kebbi State Office routinely supervised the process and validated the data. Healthcare providers were also sensitized to tactfully expose any beneficiary that did not fit the vulnerability criteria.

KECHEMA shall register the outstanding beneficiaries as soon as the State Government releases the 25% counterpart funds.

KECHEMA    is actively engaging mainstream and social media to sensitize the beneficiaries and general public on BHCPF and KECHES, to generate more demand and ensure patronage.

CAPACITY BUILDING, MONITORING AND EVALUATION ACTIVITIES:

KECHEMA, in collaboration with IHP/USAID has embarked on capacity building of staff of the Agency and those at the facility level. Four training workshops were conducted in four clusters which are: Birnin Kebbi, Yauri, Zuru and Dandi respectively.

The Agency has also printed and distributed NHIS BHCPF data tools (that were shared to the Forum of CEOs of State SHIAs recently). The tools shall be incorporated into the ICT platform of the Agency based on the NHIS M&E Framework. This will ensure complete conformity of the systems. We are waiting for the NHIS M&E framework and training on the same.

QUALITY ASSURANCE ACTIVITES:

The Agency conducts frequent visitations to the facilities that have started service delivery. From June, 2022 however when all the Seventy-Two (70 PHF and 2 SHP) were opened to enrollees. Integrated Supportive Supervision (ISS) would be instituted. Our facilities are already mapped into clusters, and internal Quality Assurance Team from all relevant departments of the Agency has been formed. The Team shall conduct monthly ISS visits to facilities. A joint NHIS and KECHEMA Team will also be created for a quarterly inspection visits to the facilities. The State NHIS office has been contacted for this purpose.

Focal persons have been selected to attend to calls from enrollees, before the Agency organizes a befitting call-centre at the Agency.

IMMEDIATE IMPACT OF BHCPF PROGRAMME IN KEBBI STATE.

1. Vulnerable groups are given equal access to quality healthcare services and are protected from catastrophic spending in accessing healthcare.
2. The programme is a reasonable and sustainable way to revitalize the primary healthcare system in Kebbi State. In barely three months of the programme PHCs have sustainable supply of commodities and are gaining more acceptance from the public.
3. BHCPF programme has further brought the Kebbi Contributory Healthcare Scheme to the fore, and more people are now joining the informal sector programme of the State’s Scheme.
4. Thanks to BHCPF programme, KECHEMA now has an ICT platform that is NITDA and NHIS compliant.
5. KECHEMA and health facility staff are trained in the implementation of a state social health insurance scheme.
6. Through BHCPF programme implementation accurate data will be generated that will be useful in health planning and research. Already, KECHEMA has distributed data collection tools from the NHIS Gateway to all participating healthcare providers.
7. Through decentralized facility financing (DFF) the BHCPF programme gives meaning to ward development committee (WDC) at the PHC level and ensures proactive community participation in the healthcare delivery in their area.

 

• KECHES Programme

• BHCPF Programme

• Enrollment Portal Dashboard

• List of accredited health facilities