Out-of-pocket payments are regarded as catastrophic because healthcare expenditures often affect the ability of a household to pay for needed care. It also contradicts the mode of payment under health insurance, where accredited hospitals provide care for enrollees without first demanding fees.
The danger in the former is that a client who is not able to deposit the required bill before treatment may not get prompt medical attention and care and may not be able to avert his or her condition deteriorating or even resulting in untimely death.
A case in point is that of Ms Pelumi Onakoya, a 25-year-old pregnant school dropout in Omi Adio, Iddo Local Government Council, Oyo State. Based on a lack of funds to seek care, Pelumi, who was in labour for two days, couldn’t go to the hospital for delivery.
Sadly, delivery, which was carried out by neighbours around her residence, was delayed because the baby had presented as breech, which led to the untimely deaths of both the mother and the unborn child.
Mrs Mary Eze, a mother of four children, began to experience discomfort in her lower abdomen, which she suspected could be signs of labour. Mrs Eze, in the company of her husband at the Adeoyo General Hospital, was, however, told that there was a major problem and the baby would be delivered through a caesarean procedure.
The Eze family was required to deposit N180,000, which they couldn’t readily provide. The experience of Mrs Eze is only one of the hundred cases where persons who need urgent medical care must first make payment before getting life-saving care and treatment, among other procedures.
While the case of Mrs Eze, whose husband quickly went cap in hand, begging for funds, was fortunate to have survived after the safe delivery of her baby, others may not be as lucky.
A case in point is that of Ms Pelumi Onakoya, a 25-year-old pregnant school dropout in Omi Adio, Iddo Local Government Council, Oyo State. She was in labour for two days and couldn’t go to the hospital for delivery.
Sadly, delivery, which was carried out by neighbours around her residence, was delayed because the baby had presented as breech, which led to the untimely deaths of both the mother and the unborn child.
However, all these could have been circumvented if women were subscribers to a health insurance policy like that offered by the Oyo State Health Insurance Agency (OYSHIA). It would have paved the way for needed quality care and prevented the untimely deaths of pregnant mothers and babies as well.
“If a woman comes to our health insurance scheme and then gets pregnant, she has access to antenatal care services, medications, required tests, and safe delivery, including through caesarean operation, when enrolled for N13,500,” said Dr Sola Akande, the Executive Secretary of Oyo State Health Insurance Agency (OYSHIA).
“If the enrollee is pregnant and in the first trimester, we ask that she pay N13,500 in three places, amounting to about N50,000, so the baby is also automatically covered for two years,” he added.
Dr Akande spoke during a two-day media dialogue tagged “Changing the Narrative on Child Mortality through Health Insurance” in Ibadan, organised by OYSHIA in collaboration with UNICEF.
He stated, “The issue with maternal mortality is not about money; it is just about ignorance of the benefits of health insurance as one of the ways to reduce personal pocket spending to access health care.
“So, we need to bridge the information gap so that people have the understanding that, through health insurance, a pregnant woman could have a safe delivery. Even the health of children, particularly those under the age of five, is well taken care of.”
Similarly, relating her experience, another enrollee, Mary Joseph, described service provision under health insurance as the OYSHIA as helpful and succour for lots of people.
“In the last two months, I have had an issue with my tongue. When I went to the hospital to seek help, they asked me to do some scans. Ordinarily, if I am not a beneficiary of health insurance, if I should do that scan outside the health scheme, I would pay N7,000 to do the scan.
“If you are not covered under a health insurance scheme, you could be spending over N100,000 for a caesarean section (CS). But if you are in a health insurance scheme and you want to do that CS, you may be asked to pay N22,200 just for the CS. So it is a very beneficial programme, and it is useful to citizens,” she declared.
In her presentation titled ‘Access To Health Insurance: ‘Gateway To Achieve Universal Health Coverage For All In Nigeria’, a health specialist with UNICEF, Dr. Ijeoma Agbo, said health insurance is a gateway to achieving universal health coverage (UHC), meant to ensure all individuals and communities have access to good health services without any financial hardship.
According to Dr Agbo, UHC is critical to reaching sustainable development goals (SDGs). In particular, concerning SDG 3, we talked about ensuring healthy lives and promoting the well-being of all.
On his part, Dr Akande described health insurance as the most viable part of healthcare financing that any country should get into as a leeway for safe mothers and safe babies, as well as a healthy, happy, and prosperous family.
“Just make sure that you are on health insurance even before you get married or that you are on health insurance even before your wife gets pregnant; that is the way forward. That is one of the ways to reduce poverty and untimely deaths in our society.
“How can people who have enrolled have better services in the various hospitals that they choose? That is the discussion on the table, and the more we attend to that, the better for us,” he concluded.
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