COMMUNITY BASED HEALTH INSURANCE (CBHI) PROGRAM IN CHEERS
Health Insurance is a system of advance financing of health expenditure through contributions, premiums or taxes paid into a common pool to pay for all or part of health services specified by a policy or plan. Health Insurance can be broadly categorized as social or private health insurance.
Community Based Health Insurance (CBHI) is a non for profit healthcare financing system which is based on solidarity and risk sharing between members within an identified community. Its major objective is to improve access to good quality and affordable health care. It also ensures that members are protected against financial catastrophe associated with illnesses. This is achieved through risk pooling and sharing, based on the contributions of participating members. It helps to improve the quality of lives of the members and their families and thereby promotes democracy. Thus in order for CBHI to succeed there must be an institutionalized arrangement designed to maximize these three key functions: (a) Revenue Collection and mobilization, (b) Pooling, which is an insurance function and (c) Revenue allocation, which is purchase of healthcare services.
In order to realize this presidential mandate through CBHI, the NHIS recognized Civil Society Organizations providing support to communities in the area of health systems strengthening as key players and therefore accredited them to facilitate CBHI activities in Nigeria.
CHEERS is one of the Non-profit making organizations acredited by National Health Insurance Scheme (NHIS) to provide Community Based Health Insurance (CBHI) scheme to identified community members and occupational based groups including religious, socio-cultural, age, youth and other groups existing within a community. CHEERS after the accreditation deployed her strategic wealth of experience in community health care financing to Bwari Area council in FCT as a pilot LGA for the CBHI program in Nigeria. This piloting process is perhaps the first of its kind in Nigeria with total involvement and ownership of the community as previous initiatives in Kwara and Akwa Ibom states had government and private sector support from the initiation to implementation of the program.
Two major communities were identified and selected for the pilot process. First is a cultural community; Bwari Area Council in FCT and the second community is disease related community; Network of People Living with HIV/AIDS in Nigeria (NEPWHAN). CHEERS management team selected these two communities because of their importance to the national health care financing systems as success recorded within these communities can easily be applied to other communities. In the course of piloting this initiative in Nigeria, two building blocks; willingness to pay and ability to pay were the focus of activities.
The following key activities have been successfully carried out in anticipation of the CBHI launching in Bwari Area Council:
- Advocacy Visits
- Round Table Dialogue
- Community Dialogue
- Community Sensitization
- Medical Outreaches
- Stakeholders Orientation Meeting
- Road show
- Registration of Association
- Constitution of BOT
- Meeting with the health facility
- Opening of account
- Registration of pregnant women
- Registration of Community members