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From Tony Osauzo, Benin
The Edo State chapter of the Association of Community Pharmacists of Nigeria, ACPN, yesterday, lamented the absence of registered pharmacists in the state Health Insurance Scheme, (EDOHIS), especially in the private accredited hospitals and clinics approved to implement the scheme.
Speaking at the 2022 Summit of the Association in Benin, the state Chairman, Mr. Duke Otite, noted that as laudable as the EDOHIS interventionist programme is, “its implementation is not all inclusive”.
He recalled the case of the 34-year old Mrs Aibangbee Rose, a mother of four, and a previously non-hypertensive patient, who was prescribed for by a physician “Tab Liptor 10mg daily x 1/12”, but an auxiliary nurse in a private clinic dispensed “Tab lisiofil 10mg daily for four days” and almost died before physicians at the University of Benin Teaching Hospital, UBTH, rescued her from hypotensive state.
He noted that such a scenario would have been avoided if the private clinic had a registered pharmacist in its employ.
“In government accredited hospitals settings, the NHIS guidelines for obtaining healthcare from the scheme is followed as the government provided the retinue of professionals including pharmacist providing care. This cannot be said of the private accredited hospitals/clinics where majority of the accredited do not have registered pharmacists in their establishment and also do not have pharmacy units registered or licensed by the Pharmacist Council of Nigeria, PCN, thereby constituting a contravention of the NHIS Act and guidelines which are prerequisites for accreditation to provide such pharmaceutical skilled services”, Otite pointed out.
He said the aberration could be “contained by accreditation of qualified community pharmacists into EDOHIS or partnering with community pharmacies”, warning that “the current and continuous exclusion of community pharmacies from the scheme is a serious concern as drugs/medicines are being dispensed without the signature and authority of a registered pharmacist as entrenched in the NHIS Act/guideline”.
The chairman on the occasion and ex-President of PSN Mr. Olumide Akintayo, in his opening remarks, also lamented that NHIS that rose to 10 percent coverage during the Olusegun Obasanjo administration, dropped to 1.7 percent in 2017, whereas Rwanda has a coverage of 90 percent.
Hr commended Edo State ACPN for organising the summit, saying that the main objective of community pharmacy is to align with the National Health Insurance Scheme, NHIS, to bring health care to the generality of the people, disclosing that so far, the scheme had appropriated about N1.5 trillion on drugs.
In his keynote address, Mr. Victor Gbenga Afolabi, lamented that Nigeria health care system is bleeding as it is currently the worst in the world, with a growing population of 200 million, less that 10 percent having access to care, low government funding and exponential raise of patient to doctor care.
He disclosed that the nation’s health sector “is financed through different sources and mechanisms. The difference in the proportionate contribution from these sources determines the extent to which such a health sector will go in achieving a successful health care financing system”, lamenting that “unfortunately, in Nigeria, achieving the correct blend of these sources remains a challenge.
“Health insurance has barely scratched the surface in Nigeria with regards to percentage coverage of the population. Ninety seven percent of Nigeria’s population is not covered by any kind of health insurance. As at 2016, only three percent of health care expenditure in Nigeria was paid for using health insurance according to PWC. While health insurance has been operational in Nigeria for over 15 years, the uptake has remained low”, he added.
Afolabi noted that most community pharmacies operate in isolation to public health care architecture, pointing out that as a result, efforts at achieving universal health insurance coverage are hampered not only by shortages in human resources for health and access points for public health care, but also by inability to leverage community pharmacists as healthcare access points.
He, therefore, stressed that the health of a country’s health care system “is fundamentally driven by the strength of its primary care system”.
The theme of the Summit was “The Indispensable Role of Community Pharmacy in Health Insurance Towards Attaining Universal Health Coverage”.
