Category: Health

The recent signing of the Cross River Health Insurance Bill into law has been described as a people-oriented policy deliberately packaged by Governor Ben Ayade to protect Cross Riverians and other Nigerians resident in Cross River from going through a catastrophe health expenditure that would further impoverish them.

Director-General, Cross River State Primary Healthcare Development Agency, Dr. Betta Edu stated this while answering questions on a topic, “The Role of Cross River State Primary HealthCare Development Agency in the Implementation of the Cross River State Health Insurance Scheme: AyadeCare” on 105.5 Paradise FM on a programme tagged “Ayade’s Cross River” anchored by Beatrice Akpala and Solomon Asha on Thursday in Calabar.

Dr. Edu who explained that the “AyadeCare” is the Cross River health insurance scheme put together to assist the state achieve universal healthcare as soon as possible and act as a form of insurance for the citizens of the state and other Nigerians living in Cross River, by ensuring that every political ward in the state do not just have access to healthcare but to quality healthcare through putting in place sustainable and smart form of healthcare financing in place for the interest of all.

“It is to act as a form of social Insurance for our people, involving pulling resources together such that we can protect citizens and persons resident in Cross River from going through catastrophe health expenditure that would further impoverish them. Cross River State led by Senator Ben Ayade is working hard at ensuring that we can achieve universal healthcare and secondly that every ward will not just have access to healthcare but have access to quality healthcare, and is helping us to ensure this by having a sustainable and smart form of health financing put in place”.

On the role of her agency, she maintained that “basically the role of the Cross River state Primary Health care Development Agency has been one of sensitization right from the onset, just as governor Ayade takes his time to do things step by step. Initially when he came into office he disclosed his intention to have a health insurance scheme in place to afford our people quality healthcare, and then he started by asking us to go to every community in Cross River to sensitize them on the need to buy into the health insurance scheme, help them have a clear understanding of what it mean by pulling our risk together and benefitting together.

“If we have to individually pay for our healthcare you know what the cost is right now with inflation everywhere and the price of everything going up and then no money available for social services, there must be an alternative, there must be something sustainable, and this is what Governor Ayade was driving at right from the onset. We have gone through the 196 Wards of the state, sensitizing the people, talking to them, getting to hear what their fears are and allaying some of the fears which they raised during the discussions, some around the fact that they have done some insurance stuff before, some with the national, some with the private insurance companies and they have not kept to their own part of the bargain.

We assured them that this system is going to be a very transparent and clear one, is going to have both the international community involve in it such that everyone can have confidence and trust that if you pay one thousand (N1000) naira every month he/she can be able to receive this care. After this sensitization, we step up by working with the State House of Assembly to put this through the legislative arm, and the Bill was sponsored by Hon. Dr. Ekpo-Ekpo Bassey, a medical doctor who know the important of Cross River achieving universal health covering before any other state in Nigeria. The bill went through the normal process, the three reading and two days ago, we had the final stamp on it, the final step which meant that we were actually at the end of the tunnel which was the assenting to that bill by the Governor. This is one of the greatest achievements of the governor Ayade’s administration”.

The DG primary healthcare Development Agency said that the N1000 is for every cross Riverian living in the state and those outside the state who feel that they have relatives in the state that their support will help protect and guarantee better healthcare for them as well as other Nigerians in Cross River, explaining that the agency is still sensitizing the people on the need to buy into the health insurance scheme.

“By sensitization, we just want to break it down to the barest minimum to help them understand it clearly, it is as simple as saying if you are diabetic or hypertensive and you have to buy a tablet or one drug or the other every day for one month, how much would that cost you, certainly it weighs more than N1000. Let say two people in one household are down with malaria and you have to get two packs of anti-malaria which will be N1200; so you have a scheme that says pay just one thousand and you have all of these cover for you. This basic sensitization to help our people understand how important and how sustainable the scheme is what we started with, and beyond this there will still be further deliberations with different stakeholders and interests groups across the state.

Talks are on with the labour which forms the formal sector to see how they can buy into it and everyone who is working in that sector to buy into it; you can’t over-emphasis the need of those from the informal sector to buy in which will involve cooperatives, Churches and different groups buying into what is already ongoing. Beyond this, individuals, politicians etc. are encourage to buy into what is going on. You could pick up a health bill for 100 persons’ in your community to ensure that they have access to quality healthcare. We would equally be expecting some gifts and donations from philanthropist individuals, partnership from donor agencies, the World Bank and the government which the commitment is already there to ensure that the state healthcare insurance kicks off immediately and meets its target of providing universal healthcare to Cross Riverians”.

She assured cross Riverians that the administration of Senator Ayade meant well for them as regards the State Health Insurance, stating that it is based on this reality that while signing the bill into law the governor clearly said that the health insurance funds will not be handle by government nor its agencies, because government is not a health insurance company stressing that the process for the selection of Health maintenance Organizations (HMOs) would be supervised by International partners, while government will insist that they would be HMOs take qualitative healthcare to the door steps of the people .

Dr. Edu stated that the leadership with ethics policy of Ayade’s administration came to bear in the final document of the Health Insurance law as those less than 18 years, pregnant women, the physically and mentally challenged as well as the very poor and indigent persons are exempted from the monthly health insurance premium of N1000 but are entitled to full medical benefits and allay the fears of those already paying health insurance premium at the national or private health insurance companies that discussion and modalities would be put in place to ensure that such persons also enjoy from the state health insurance, as the programme is comprehensive covering all aspects of medical, while the payment comes from above, adding she thanked all the foreign partners for assisting in the various programmes of the agency for their support.

Speaking further on the benefits associated with the state health insurance, Dr. Edu explained that the Cross river Health Insurance, AyadeCare is a form of risk sharing, that guarantees that at any point that oneself, one’s brother/sister parents or any Cross Riverian is sick, that person or persons do not need to have money in his /her pocket but can just walk to the nearest health facility and access healthcare free of charge at the point of utilization.

“As you pay this token you are giving a shoulder for another person to lean on, sacrifice is a contribution which you will benefit, they will benefit, we sharing the risk, sharing the benefits, we are preventing individuals, families at this point where we have an economic recession from going into a state where we would say they have catastrophe health expenditure and they are now impoverished. You know some time people come down with illnesses like cancer and the family spend so much to take care of them that impoverished not just one generation but it cascade down to yet another generation, that is what this form of health financing can help us overcome, that is what the Cross River State Health Insurance Scheme, AyadeCare can help us to overcome.

For us the watch word is universal health coverage, health access, we want everyone to have access to healthcare whether you are in the rich middle or low cadre, whichever class, we want you to access healthcare that you deserved. What the AyadeCare stand for, what the state insurance scheme stands to achieve for Cross River State is beyond party, is beyond Ayade himself, beyond the government of Cross River State. Our healthcare insurance for us as a people, by us as a people, it is a brother giving a shoulder to another brother, its sacrifice to ensure that everyone can live healthy and make productive contributing to our state. We call on every one , if you are a politician in any party, this is beyond party lines , let’s all buy into the state health insurance, let’s get our families, friends, members of our wards insured as part of empowerment is to ensure that your people are healthy”.

On her achievements since she assumed office, Dr. Edu said, explained that she started Special Adviser on Primary health and community health and part of what her first assignment was to liaise with the Federal Government to put together an Agency and by March this year, governor Ayade after going through all the recommendations and appropriate steps, the agency was established with the Board put in place which hitherto has been dragging for five years going.

She disclosed thus, “We have been able to step up our immunization coverage on several immunizations exercises to the 100 percent mark which we were greatly commended by the Federal Government of Nigeria. Most of the primary healthcare centres when we came on board were all in a very abysmal state and we decided that rather than going on to build more primary healthcare centres and putting in much more money, why don’t we limit ourselves to making what already exists functional. So we first of all went about getting out one primary healthcare centre in every ward in cross River state such that you can ensure that 3000 persons can have access to quality healthcare.

After earmarking these primary health centres we wanted to begin our intervention with, we selected the first four and as we speak, we have completed that, two of which the wife of the present, Mrs. Aisha Buhari came in person to commission at Ikom, Itayep and Ajijinkpo all in Ikom LGA with the wife of the governor, Dr. Linda Ayade. Beyond this, we have repaired and fully refurbished the primary healthcare centres at Anengeje and the primary healthcentre at Bedia in Obudu, we have done the primary health centre in Biase LGA which is still awaiting commissioning. Our target is to get at least one functional primary health Centre in every ward which will serve as the hub for other primary healthcare facilities in that ward, it will serve as the referral point and anything that goes above that centre then it will be refer to the secondary level of care which is the General hospitals in the various locations. Beyond this we have been able to bring in solar power panels for our immunizations and coaching equipment, solar electricity into our maternity wards, labour rooms, emergency areas in about 50 primary healthcare centres across the state with support from “We care solar and pathfinder international.

Last two months, Governor Ayade employed 18 medical doctors and sent them to the 18n LGAS of the state to boost health services in these LGAs, so they can give some assistance to the midwives, nurses and other medical personnel already working at this level. We had several donations from several sources ranging from solar refrigerators for our vaccines which is to keep them potent to the point we can deliver them to our children to prevent our children from coming down with vaccine preventable diseases. We had other donations that have help to improve healthcare at the primary healthcare level.

We are far from where we want to be but we have the support of the Governor, Senator Ben Ayade and we are working with partners to see how we can even at this point of economic downturn where [people are pulling out from social services because they do not generate revenue for government, we have a committed governor who is rather putting into social services, who is pro-poor, who is pro–health striving to improve the healthcare delivery in Cross River. We know that if they have good health, then they can become productive and it will also rob off positively in our economy in general”, Dr. Edu concluded.

Cross River State Deputy Governor, Prof. Ivara Esu on the 8th of September, 2016 at University of Calabar Teaching Hospital (UCTH) launched a society of gynaecology and obstetrics of Nigeria (SOCON) program “Volunteers Obstetricians Scheme (VOS).

VOS is a scheme of SOCON in partnership with Federal Ministry of Health and National Primary Healthcare Development Agency and other state partners aimed at impacting on pregnant women in the rural areas and reducing maternal morbidity and mortality. Speaking, the deputy Governor who was ably  represented by the state Commissioner of Health, Dr Inyang Asibong said the program is coming in when the high rate of maternal morbidity and mortality is increasing in the state while lauding SOCON for the initiative, she hopes to partner with them to battle maternal morbidity and mortality in the state.

She went further to tasked the volunteers to go into the field, get accurate data and provide their technical assistance to health facilities accros the state. Dr Asibong officially inaugurated the VOS team.

Also speaking, Her Excellency, Dr Linda Ayade who was represented DG Cross River State Primary Healthcare Development Agency (CRSPHCDA) Dr Betta Edu in her statements noted that VOS is very vital to the reduction of maternal mortality in the state.

She went further to disclose effort of Cross River State Government on revitalizing primary healthcare in the state so as to provide basic obstetric care for women in remote areas. This according to her was made possible by the visionary Governor of the state, Sen (Prof) Ben Ayade who has just signed two vital bill into law in a space of one month, first the state primary healthcare development agency and State Health Insurance Scheme laws. She said all this laws were spearheaded by the Chairman House Committee on Health, Hon (Dr) Ekpo Ekpo Bassey. She explained that through the Ayade Care (SHIS) there will be a sustainable source of funding for health care which will cater for our women and ensure Universal Health Coverage in CRS. People in the rural areas will have access to 24 hours healthcare services at functional PHCs, general hospitals and specialist world class hospitals in the state.

According to her, part of the state effort to reduce maternal morbidity and mortality is the recent recruitment of medical doctors for PHCs across the state to support the few midwives and nurses in handling complicated cases that will lead to death of woman or baby. Finally she said the VOS program she help with community sensitization to reduce the growing rate of unskilled birth attendants.

Earlier speaking, Deputy CMAC UCTH, Dr Ogbu Ngim who was representing CMD said the program has received full back up from federal ministry of health while urging the state to consolidate on it as an alternative to tackling the growing rate of maternal morbidity and mortality in the state. She tasked the organization to monitor the process and ensure its fully implementation in the rural areas.

House Committee Chairman on Health, Hon ( Dr). Ekpo Ekpo Bassey lend his voice by assuring SOCON the initiators of VOS program of legislative back up. He said their major concern have always been the growing rate of maternal morbidity and mortality in the state. “That is why we have successfully passed two effective bills on health into law, the creation of State Primary Healthcare Agency and State Health Insurance Scheme. He lauded SOCON for the wonderful initiative while he prayed for the success of the scheme.

Presentations on birth preparedness ‘a veritable tool in preventing maternal mortality and way forward were taken by Prof John Ekabua and Prof E.E.J Asuquo. Others presenters at the event were Prof Eric Archibong Dr Ekot who is the head of VOS CRS, NMA chairman, MWAN president Dr Nchewi Ani and Dr Akpanika.

Desirous of ensuring quality and affordable health care across the broad spectrum of the citizenry, Cross River State governor, Prof Ben Ayade, today , signed into law the state’s Health Insurance bill.

Tagged: “AYADECARE“, the law seeks to provide medical insurance cover at primary, secondary and tertiary levels for the old, the young, including the weak and the strong in the state.

When it comes into operation, the law also provides for a mandatory monthly fee of N1000.00 from every adult citizen and resident of not less than 18 years.

Performing the ceremony at Executive Chamber of the Governor’s Office Calabar, Ayade disclosed that the intent of the bill will ensure that “the strong pays for those who are medically challenged,” adding that “the law provides very expressly that a minimum of N1000.00 monthly, will be paid by every Cross Riverian as well as those residing in the state.”

Continuing, the governor explained that “the N1000 becomes your insurance for that month and that gives you access to full medical attention including diagnosis, transplant, surgeries among others.”

Ayade who described the bill as most spiritual, noted that “it derives its origin from a true communitarian African culture which enjoins us to provide a shoulder for others to lean on.”

He added that “there can be no bill that is more humanitarian, human focused, sensitive and delicate like this. It is a message for all including residents in the state as they are captured in the bill, for we believe in the love for strangers and visitors.”

On the management of funds accruing form the scheme, Governor Ayade explained that “government rose to the task in order to protect the vulnerable, sick, physically challenged and the weak,” maintaining that “the administration, as part of its policies, will have nothing to do with the funds that will emanate from the scheme, but will help to enforce payment.”

While urging the state legislators to set up an operational committee that will draw the modality, the governor quipped: “Today, the medical challenges of our citizens have been taken away and placed on this platform that every one of us will now contribute to support our people.”

He intimated that the law which provides for primary, secondary and tertiary medical services would ensure the setting up of specialist health care centres across the three senatorial districts of the state to provide for the medical challenges of the citizenry.

Speaking on on the international dimension of the new law Governor Ayade further disclosed that “this is the kind of bill that the World Bank, United Nations, UNICEF will be quick to fund and support.”

On the action plan, the governor charged the committee that is yet to be inaugurated to: “Let us first start by creating the infrastructure which is to set up an action team so that everybody gets involved. Think of where in the Central, North or South are we going to set up these three medical centres of excellence. Once that is identified, the mechanism for collection starts, the design of the medical centres follow.” According to him, “once that is done, the world-class group will start the design and construction. All of these, of course, will be outside the control of government because I don’t want this government to be involved in touching a dime from this fund.”

BY BETTA EDU

A popular saying goes, “Health is Wealth” and as much as that is self explanatory, people always overlook the fact that in Health, every little thing matters from our decision to seek care on time, to our attitude towards Alcohol, the food we consume and importantly, the policies of government on health.

There is no gainsaying that Nigerians and indeed Cross Riverians wish our health system and infrastructure are as perfect as we see in Hollywood or foreign movie productions(this we deserve) but fail to support and see through some very vital policy and legislative framework of Government partly due to the failure in the full implementation of some Health policies and regulatory frameworks by Government. However, there is a wind of positive change blowing in this regard and there is need for Cross Riverians to see through it, that is why this peek into the future is necessary.

Imagine these two situations; First, a woman in Labor in Calabar South visits a nearby medical facility where complications arise and she needs medical attention which is way above her income and because she cannot raise the sum, dies or better still she resorts to a prayer house or Traditional birth attendant and loses her life and that of her baby in the process.

The Second is of a petty farmer whose family’s annual income is less than 50,000 Naira and is diagnosed of Cancer but receives treatment in a state of the art medical facility in the state free of charge because she and her family are enrolled in With “AYADE CARE” (State Health Insurance Scheme). Too good to be true? well let us wait and see.

The health sector in Cross River State has not had a smooth ride, a common phenomenon with every other sector. However, the health pyramid starting at its base, the Primary Health System to the Tertiary and advanced tertiary is currently receiving a boost.

The challenges plaguing the sector range from the failure in the implementation of the Alma Ata declaration of the 70’s and several other health policies which almost degenerated to a riot of sort as basic health care (like care for uncomplicated malaria, skin rashes etc)was now provided by tertiary facilities due to the lack of quality primary health care for the over 70% of our population living in the rural areas, the decay in infrastructure, lack of human resourses among other reasons inverted the pyramid.

The journey to surmounting these challenges began in 2011 following the passage of the State Primary Health Bill which came with some congenital malformations, though not implemented, helped organized the system in a structure that positioned it for efficiency.

5 years later, we now have a fully functional State Primary Health Care Development Agency with a view to position the state to benefit fully from the provisions in the National Primary Health Care act and revert the health pyramid to sit on its base (meaning the primary health care centers will handle most of the illnesses in the community with special cases going to the secondary and tertiary health institutions.

Recently, the Federal Government lauded the state’s performance in the implementation of the “Primary Health Care Under One Roof Policy” announcing that Cross River was far ahead of other states despite receiving almost the least allocation from the central coffers and called on other states to emulate us!. The current health team headed by the Governor, Senator Ben Ayade, his wife, Dr. Linda Ayade, the health commissioner, Dr. Inyang Asibong and yours faithfully Dr. Betta Edu upon assumption of offices, folded sleeves and set out straight to work to ensure that despite the negative economic indices, Cross Riverians get the maximum available, in terms of effective, affordable and quality health care services with a true Negro-Anthropological drive of a brother providing a shoulder for his brother, to lean on.

How? Cross River State currently has 1,013 Primary Health Care facilities built by Government, Communities and Concerned individuals over the years and with the coming of the agency, the state is better positioned to access the National Primary Health Fund, including the USD1.5 million and several other intervention funds(although the funds have not been given to the state yet) but when recieved will go a long way in giving these facilities a facelift, provide drugs, hire skilled health workers and provide quality health services 24hrs.

The secondary and tertiary institutions are not left out as the “Ayade Care” (State Health Insurance Scheme) law which has just been assented to by the proactive proHealth  Governor Ben Ayade which is a replica of the National Health Insurance Scheme with modifications that makes the financial burden so minimal that some elites and stakeholders think the premium is to small as such must be a joke.

The scheme will see all Cross Riverians subscribe with a minimal fee of 1,000 Naira per month, that is 12,000 per annum, yet will have access to quality Medicare. The state plans to really turn the state into a medical tourism haven of which discussions are ongoing with investors and partners across the globe.

The plan to achieve Universal Health Coverage by the end of 2017 is well on course and with the support of Cross Riverians, it will be achieved. That will be another landmark achievement for a state known to blaze the trail which is currently been led by a trailblazer.

Cross Riverians are known for warmth, hospitality and care. The plans of the current administration in the health sector will eventually lead us to have that Health System we see in foreign movie productions, or at least close to it. But, Cross Riverians need to see through it, ask questions and seek clarifications and not outrightly condemn policies, white papers or regulatory frameworks of government because of trivial sentiments.

If every cross riverian within and outside CRS put in 1000, every politician empower their ward members by paying for their health bills, 1000 per month, if we all work at this, sucess will be achieved. It is beyond the government, its beyond party, it is for our people by our people!

The future is bright for Health in Cross River State. There are still challenges, especially in the area of funding, equipment and perception of Cross Riverians in the grassroots on accessing healthcare. But, together we can achieve that health sector of our dream. INDEED AYADE CARES!!!!!!!

BETTA EDU IS THE MAIDEN DIRECTOR GENERAL OF THE CROSS RIVER STATE PRIMARY HEALTH CARE DEVELOPMENT AGENCY


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