Sokoto’s Gift to Its Citizens

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Call it a milestone or uncommon feat, scaling through religious, traditional and even financial bottlenecks to have the Contributory Health Scheme launched in Sokoto State is but a pragmatic approach to subduing the problem of uneven distribution of healthcare services. Peace Obi reports

The health of a nation, they say is the wealth of a nation. This statement though simple and factual, yet may not pass a reality test in many climes. Hence, this statement may also become irrelevant if Nigeria’s healthcare delivery system should be considered as a yardstick. But a recent launch of a Community Contributory Health Scheme (CCHS) by Sokoto State government is a confirmation of a government that believes that the wealth of the state lies so much with the healthiness of the people.

The Sokoto State Governor, Aminu Waziri Tambuwal, determined to reduce the high morbidity and mortality rates occasioned by lack of access to healthcare services, among others, through the introduction CCHS – the state’s version of the National Health Insurance Scheme appears to be saying to residents of Sokoto, you deserve to live and not die.

The governor had at the resumption of office in May 2015 marked out health, education, housing, among others as areas deserving critical attention.
With a mind to bring governance closer to the people, and give residents of Sokoto State reasons to cherish and live a meaningful life, he has made some radical social interventions, especially in the health sector. While incubating the new health policy, Tambuwal had in a quiet but pronounced steps towards ameliorating the sufferings of the less-privileged sick persons in the state announced that the state government’s decision to set aside N10 million every month for free drugs. According to the governor, the government cannot afford watching her human resources die in their numbers for lack of money for medication. The set aside funds, which was to herald the community contributory scheme were kept in selected hospitals and pharmaceutical stores in different parts of the state for easy access. And that brought hope and relief to the extremely poor citizens to access prescribed drugs.

Carefully wading through the curb-webs of tradition, culture and religion, but armed with the weapon of consultation, Tambuwal mobilised the necessary support from different quarters bringing into place a healthcare programme he said would bring healthcare services closer to his people.

Speaking at the event in Sokoto recently, Tambuwal noted that CCHS is one of the measures the state has adopted towards ensuring effective healthcare delivery and subsequently, the attainment of Universal Health Coverage. Adding that it is an important policy that its impact will positively affect the lives of the people, Tambuwal said that the scheme would also ensure equitable distribution of healthcare services across income groups in the state.

“It will also protect families from the financial hardship of huge medical bills and limit the inflationary rise in the cost of healthcare services in all parts of the state.
“Apart from ensuring equitable distribution of healthcare costs across different income groups, this scheme will improve and harness private sector participation in the provision of healthcare services in Sokoto,” he said.

Announcing the take off sum of N100 million as the state government’s first contribution to the scheme, the governor hinted that the government had set aside the seed fund for the commencement of the scheme to ensure proper implementation. Adding that the state is committed “to develop and implement appropriate policies and programmes that will strengthen the State Health System in order to deliver effective, quality and affordable health care services.”
With the initial commitment of N100 million to the newly established Sokoto State Contributory Healthcare Management Agency, the governor urged wealthy people in the state to contribute to the new agency. According to him, a sustainable and successful universal health coverage in the state will be much achieved through the various stakeholders’ contributions.

Many observers have said that the recent development in the state health sector might have been heightened by the governor’s unscheduled late night visits to the public hospitals to assess the situation of things by himself. Seeing they say, is believing. The sector was said to have felt the impact of the Govenor’s personal visits with the increment in allowances paid to different healthcare workers who frequent rural areas daily to render services to those in need. Also, realising that distance and lack of access to life-saving drugs are some of the major causes of child mortality and in some cases death arising from childbirth, the government began distribution of free drugs to pregnant women and those who give birth in public hospitals or private healthcare centres under government supervision in the rural areas. In addition to the provision of free drugs, government has passed legislation that has transformed the delivery of service in the primary healthcare sub-sector. The state’s PHCs under-one-roof policy has streamlined control and removed unnecessary bureaucracy in the implementation of health goals in Sokoto State.

To broaden its healthcare service delivery, reach and acceptability of the new healthcare policy, consultation with stakeholders was initiated. To cover all interest and allay all fears, the Governor in a one-day sensitisation workshop on the merit of the contributory healthcare scheme noted that seeking the views of religious scholars and traditional rulers is essential for its future success. According to him, the consultations became necessary so as to mobilise all stakeholders, and the people of the state, in order to ensure the success of the objectives of the project. And faced with the onerous task of assuring Sokoto residents that government’s new idea, approach and policy on healthcare delivery are harmless steps with the goal giving every member of that society an opportunity to live a healthy life. Tambuwal explained that the state’s NHIS model was in line with their culture and religion.

“We know insurance is not permissible in Islam, the reason why some Muslims kicked against health insurance scheme, but be rest assured that our model is quite different as it entails contributing money to assist those who cannot afford medication which is permitted in Islam,” Tambuwal explained. Not leaving any stone unturned, the Governor disclosed that some aspects of the state laws will be amended to accommodate the scheme. And commending the NHIS management for its support in introducing the state model, the governor said that his government would collaborate with the NHIS to meet required objectives.
Recalling how he prevented the diversion of funds meant for the state’s NHIS when he was the Speaker of the House of Representatives, he said he would never risk the life of his people and never wanted to get involved in any form of illegality. “When I was the Speaker, people were approaching me that there is huge amount of money in the scheme that I should talk so that the money would be lodged in a secret account where it would yield a lot of interest which we can share among ourselves but I declined. I told them I cannot be part of any illegality,” he said.

The Sultan of Sokoto, Muhammad Sa’ad Abubakar in his remarks dispelled the notion that Islam is against contributory scheme, he however noted that consultation with relevant stakeholders is the way to go. According to him, Islam encourages members of the society to help each other at all times. “It is now that the NHIS has started working because you are involving religious and traditional leaders who would guide you in the implementation of the new scheme and will carry your message down to the grassroots. I urge you to reach out to other religious faithfuls too,” he said.

In his remarks, the Chief Executive Secretary, NHIS, Professor Usman Yusuf said that the scheme was initiated to ensure that every Nigerian has access to qualitative and affordable health services in the country.
Speaking on the benefits of the workshop, Yusuf said it was aimed at educating the people, particularly traditional rulers and religious leaders on the need to make them have a good understanding and as well realise their role in the new scheme which he said was not against their religion.

Enumerating on some of the benefits of the new scheme, the state Commissioner for Health, Kakale Shuni, said the new health programme would ensure that residents of Sokoto have access to effective, quality and affordable healthcare services.

“It will facilitate training of human resource development and ensure availability of alternative source of funding to the health sector for improved service,” Shuni said.

The focus of every responsible leadership is the improvement of the wellbeing of all strata of the governed and it was in consideration of this that the Sokoto State government approved the strengthening and improving the school health system aimed at ensuring that, schools have designated clinics where basic care for health challenges of students are managed. As part of effort to achieve the set objectives in that direction, the state ministry of health is collaborating with the ministries of Basic Education, Higher Education and Almajiri school, has already executed the directive.

In addition, the state government, in collaboration with development partners, has upgraded the state central medical store to international grade which now serves all the seven states in the North West geo-political zone of the country. The store is used in the preservation of all drugs so as to control their quality and efficacy. Presently in Sokoto, each hospital has been directed to establish a drug revolving fund, sanitation and other committees where communities are involved in strengthen system. By this, free drugs and nutritional support are given to children under the maternal and antenatal health policy toward pregnant women and children.