I received a message from my home in Imo state. It was sent to me by a family member. The message was titled ‘Imo State Health Insurance Scheme’, and reads: “For your information, above is a scheme whereby if you enrol with a sum of N15,000, you will get free medical care from government hospitals for any other ailment except cancer.” The message ended with further information which read “This enrollment is renewable every year.” On further enquiry, I confirmed that officials of the State Ministry of Health were around on Tuesday, May 20, at the Ideato-South council headquarters in Dikenafai, to enrol people of the local government areas into the scheme.
This bit of ‘breaking news’ brightened my day which was made gloomy by the uninspiring realities on Nigeria’s economic boulevard. It put a smile back on my face. The reason is simple. When you imagine the cost of medical care in today’s Nigeria, with the treatment of ordinary malaria rising to above N20,000, that is, for an outpatient, then, you will appreciate the meaning of my excitement. I am excited because, for N15,000 only, anyone in Imo state can now access medical care for 12 calendar months under the Imo State Health Insurance Scheme. This translates into financial protection against healthcare costs that cover a comprehensive range of services, including emergency surgeries, maternal care, and neonatal care.
For people living in Imo rural communities, this is a huge leap forward especially when because the high cost of medicines has forced the sick to seek succour in unorthodox medicine, with the attendant implications. Get my drift; herbal medicine is not bad. However, the unregulated nature of its dosage leaves people with different risks to vital internal body organs. Therefore, providing people with the opportunity to access healthcare for all ailments, except cancer, at N15,000 per annum, is revolutionary. It is commendable too.
From my investigation, the new healthcare policy, designed by Governor Hope Uzodimma, and christened “Imo Roadmap to Universal Health Coverage,” is not only about the massive enrollment of people in the 654 communities in Imo state into the health insurance programme, aptly called ImoCare; the package consists also of the building, and equipping, of new primary healthcare centres in the 305 electoral wards in the state to make them render effective service to the people. The roadmap prioritizes strengthening PHC services, investments in infrastructure, human resources, and quality improvement which will increase trust and utilization of PHC facilities. Further, it comes with a programme for the strengthening of human resources in the healthcare sector through massive recruitment of healthcare professionals for the state.
The healthcare policy is also designed to ensure the retention of trained healthcare workers for the state through the implementation of a new salary structure for healthcare workers; and the training of doctors, nurses, pharmacists, laboratory scientists, and opticians among other professionals in the sector. Also, Governor Uzodimma has promised to build additional general hospitals that would serve as referral hospitals to primary healthcare centres. These will be supported by the upgrade of the Imo Specialist Hospital and Imo State University Teaching Hospital to serve as referral tertiary healthcare facilities in the state as well as the building of a new drugs stocking facility and management control system that will ensure the availability of essential medicines for use in the state hospitals.
The ImoCare roadmap aligns with Nigeria’s national healthcare policies, particularly the Basic Health Care Provision Fund (BHCPF), which supports mandatory health insurance laws. Gov. Uzodimma’s efforts to implement these policies are also strengthened by the World Health Organisation’s commitment to helping Imo achieve at least 80% population coverage. The percentage is considered a benchmark for Universal Health Coverage (UHC). It is recalled that the global push for UHC, as articulated in the United Nations Sustainable Development Goals (SDGs) and the WHO’s 13th General Programme of Work, emphasized equitable access to essential health services. In Nigeria, the federal government’s Basic Health Care Provision Fund, launched in 2023, provided a framework for states to expand health coverage.
Also, the WHO, through the UHC partnership, played a pivotal role in shaping the new ImoCare roadmap. It supported the creation of the State Health Financing Unit and a Technical Working Group within the State Ministry of Health. These were tasked with generating evidence, building capacity, and developing operational guidelines for the Imo State Health Insurance Agency (ISHIS). WHO also supported the training of the Imo State Health Insurance Agency (ISHIA) staff and further advocated for stakeholder engagements and buy-ins across formal and informal sectors, including labour unions, traders’ associations, and traditional institutions.
With these actions, Governor Uzodimma is gradually revolutionizing healthcare in Imo state. Excitedly, the state has emerged as a notable case study in advancing universal health care through innovative health financing and insurance schemes. Meanwhile, this is not the first time that Governor Uzodinma has taken steps to revolutionise access to healthcare in Imo. On August 19, 2020, he launched the Mobile Health Insurance Programme, a first-of-its-kind initiative in Africa. It was designed with WHO’s technical support and utilized mobile phone technology to facilitate enrollment and payment for health insurance. It enhanced accessibility by allowing seamless enrollment, and payment, and reducing administrative barriers.
Governor Uzodimma has demonstrated strong leadership in driving this key reform programme. His action underscores the importance of political commitment and will in achieving UHC in Imo state. His result-oriented collaboration with WHO and alignment with national policies have also strengthened the Imo healthcare system and highlighted the value of multi-stakeholder engagement in delivering on promises while also demonstrating the importance of involving traditional rulers, traders, and other stakeholders in fostering acceptance of new schemes and utilization of health services.
Before this, Imo state faced significant health challenges, including high out-of-pocket expenditure for healthcare, a maternal mortality ratio of 576 per 100,000 live births, and an under-five mortality rate of 96 per 1,000 live births. Available statistics indicate that over 90% of the Imo population lacks health insurance, despite a high literacy rate of about 87%. These statistics are part of the reasons for Governor Uzodimma’s determination to provide Imo state with a robust health financing system that aims to reduce the financial barriers to healthcare access.