The right to health is recognized as a fundamental human right by the World Health Organization (WHO) and is enshrined in the Universal Declaration of Human Rights. However, access to healthcare and health insurance varies widely across different countries and populations.
Health insurance is one way to help ensure access to healthcare for individuals and families. It can provide financial protection against the high costs of medical treatment, which can be a barrier to seeking care. In countries with public health insurance systems, such as Canada and the United Kingdom, access to healthcare is considered a universal right and is provided to all citizens.
In other countries, such as the United States, access to healthcare and health insurance is not universal and can depend on factors such as employment status and income. The Affordable Care Act (ACA), also known as Obamacare, was a significant step towards expanding access to health insurance for Americans. The ACA introduced measures such as insurance marketplaces, subsidies for low-income individuals, and protections for individuals with pre-existing conditions
In Nigeria, the Adamawa State Contributory Health Management Agency and the Right to Health Cluster of the Strengthening Civic Advocacy and Local Engagement (SCALE) project of the United States Agency for International Development (USAID) implemented by Palladium are two critical programmes aimed at improving healthcare access and outcomes for citizens.
The Adamawa State Contributory Health Management Agency is a state-owned agency established in 2016 to administer health insurance in the state. The agency operates under the Adamawa State Contributory Health Management Law, which mandates all residents of Adamawa State to be covered by the scheme. The scheme aims to provide quality and affordable healthcare services to citizens, particularly those in the informal sector, through a prepayment mechanism.
The scheme is structured to allow enrollees to pay a premium, which is based on their income, and in turn, receive healthcare services at any accredited healthcare facility in the state. The scheme covers essential health services such as hospitalization, surgery, maternal and child health services, and treatment for communicable and non-communicable diseases. The agency has partnered with over 100 healthcare facilities across the state, including primary healthcare centers, general hospitals, and private hospitals, to provide healthcare services to enrollees.
Since its establishment, the agency has made significant strides in improving healthcare access and outcomes for residents of Adamawa State. As of 2021, over 600,000 individuals have enrolled in the scheme, with over 300,000 claims processed and paid by the agency. The agency has also embarked on several initiatives to improve the quality of healthcare services provided to enrollees, including the accreditation of healthcare facilities, training and retraining of healthcare workers, and the deployment of technology to improve service delivery.
The Right to Health Cluster of the SCALE project which is anchored by the Centre for Social Justice (CSJ) is an important project aimed at improving healthcare access and outcomes in Nigeria and particularly in Abuja and 7 focal states of Sokoto, Adamawa, Nasarawa, Imo, Ekiti, Bauchi and Rivers. The project focuses on improvements in the realization of the right to health in Nigeria through enhancing respect for extant laws and policies, reforming laws and policies as well as mainstreaming transparency and accountability in public health sector expenditure.
The #Right2Health Cluster of the project specifically focuses on advocating for the realization of the right to health for all Nigerians. The cluster works with civil society organizations and community-based organizations to raise awareness on the right to health, promote citizen participation in healthcare decision-making, and advocate for the implementation of policies that ensure universal access to quality healthcare services.
Since its inception, the #Right2Health Cluster with its Adamawa State partner, Women & Youth Empowerment for Advancement and Health Initiative (WYEAHI) has achieved significant milestones in promoting the right to health in Nigeria. The cluster has worked with civil society organizations to develop and implement advocacy campaigns aimed at improving healthcare access and outcomes for citizens. The cluster has also supported the development of healthcare policies and frameworks that prioritize the needs of citizens, particularly vulnerable populations such as women, children, and persons with disabilities.
The cluster has also leveraged technology to promote the right to health in Nigeria. Through the use of social media and other digital platforms, the cluster has raised awareness on the importance of the right to health and promoted citizen participation in healthcare decision-making.
The Women & Youth Empowerment for Advancement and Health Initiative (WYEAHI) and the Centre for Social Justice and the Right to Health Project have made significant contributions to the healthcare sector in Adamawa State. These initiatives have increased access to quality healthcare services, reduced the burden of out-of-pocket expenses on households, and improved the quality of healthcare services in the state.
However, there are still significant challenges that need to be addressed to improve healthcare delivery in the state. These challenges include inadequate funding for healthcare, insufficient healthcare personnel, and inadequate healthcare facilities. Addressing these challenges requires sustained efforts from all stakeholders, including the government, healthcare providers, and the private sector.
Okeke writes from the Centre for Social Justice (CSJ) Nigeria
