The majority of Nigeria’s population live in poverty. Poverty is especially severe in the rural areas, where social services and infrastructure are limited or non-existent. When people in the rural communities are sick, the first and nearest health facility to them is the Primary Health Centre (PHC) but unfortunately most people cannot access services at these health facilities because of fee for service (Out of Pocket Payment).

In order to eliminate the out of pocket payment that makes access to quality and affordable healthcare services inequitable mostly among the indigent vulnerable groups (Pregnant women and children under five years old), Ukana West 2 Community Based Health Insurance (CBHI) Scheme was launched on the 21st August, 2014 in the Primary Health Centre, Ikot Ideh, Essien Udim Local Government Area, Akwa Ibom State, Nigeria. CBHI is a non-for-profit organization that provides risk pooling (protection) to cover the cost of health care services. The program is managed by democratically elected members of the community and supervised by different stakeholders. CBHI is actively involved in resource mobilization and health sensitization programs in the communities. It also partners with the NHIS (National Health Insurance Scheme) and other relevant organizations to identify the indigent vulnerable groups and ensure that they have equitable access to quality and affordable healthcare services in the Primary Health Centre, Ikot Ideh. In this scheme, every financially-able person in the community pays (₦5, 000) 12.95 USD per head per annum to enjoy the program.

woman in health centre looking through records

Before the inception of CBHI, the Primary Health Centre Ikot Ideh had many problems including: inefficiency, lack of drug supply, high fee for services, lack of staff, poor service uptake as well as poot documentation of service uptake. Maternal mothers therefore resorted to fraudulent medical practitioners for health services. Since the inception of CBHI in 2014, there is a lot of improvement including an increase in the service uptake by pregnant women and children under five years old in the health facility from qualified medical attendance.

patients in health centre waiting room

Having CBHI in a Primary Health Centre and allowing the community to own and manage the program ensures that the health facility is functional and accountable. CBHI ensures that there is equitable access to quality healthcare services for all irrespective of their financial status. It also ensures availability of drugs, access to certified medical professionals and quality maternal and child care. Within CBHI many babies are delivered in the health facility. Additionally, CBHI advocates for improved health financing, for the establishment of the State Health Insurance Agency, health sensitization programs, partners with relevant organizations to provide trainings for community health, and provides incentives to the health workers. In 2018 and 2019, CBHI received supporting grant from the Global Universal Health Coverage Stakeholders to mark Universal Health Coverage Day in Akwa Ibom State, Nigeria.

mothers and babies in health centre

Note: Each story has been edited for clarity and in cases, shortened for fit on the UHC2030 webpage.

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