THE BLOG

A Healthy Woman Is an Empowered Woman - The Alaafia Universal Health Coverage Scheme

10/03/2015 01:54 | Updated 06 May 2015

As the world gathers to celebrate International Women's Day on Sunday, this year's theme 'Empowering women, Empowering humanity: Picture it!' resonates with me deeply, particularly in the run up to Wellbeing Foundation Africa's (WBFA) eleventh anniversary, next week. Empowering women - with a focus on maternal, newborn, and child health - has been my mission in Nigeria and across the African continent over the past decade. Women's health has long been neglected in Nigeria, with an estimated 36 000 women dying each year in pregnancy or during childbirth.

We have faced a number of challenges in our goal to empower women in Nigeria - battling cultural stigmas towards women's health issues, battling inertia on women's rights within the Nigerian legislature, and battling a lack of infrastructure within our health systems that cannot provide adequate or respectful healthcare for our people. Yet, women - their rights and their health - remain our focus because if we can empower women, we can empower Nigeria, the African continent, and indeed, humanity as a whole.

Since establishing WBFA in 2004, it has been a continuous learning process. The Foundation is continually learning, refining our interventions and working with partners to deliver successful solutions like the Personal Health Record in Nigeria. Our successes over the course of the last decade have been inspiring, with our frontline health programmes like the Positive Lifeline Programme, Twins and Multiple Births Programme and Indigent Medical Fund helping thousands of lives since their establishment. Nonetheless, on this key milestone, it is important to turn inward and see how we can recalibrate our approach to achieve even more success over the next ten years.

Through these three programmes, WBFA and I have intervened to assist with out-of-pocket medical bills and the cost of specialist healthcare for patients in need. However, we have found that this model, whilst successful, is ultimately unsustainable. Reaching the 1 in 20 women who die during childbirth in Nigeria and fundamentally transforming how we approach primary healthcare as a nation will require a more comprehensive and innovative financing mechanism.

In my home state of Kwara, in north-central Nigeria, the state government worked with local health insurance companies and international partners like PharmAccess Foundation to provide low-income families with equitable access to affordable and quality healthcare services through the world renowned Kwara State Community Health Insurance Scheme (CHIS). The donor-subsidised CHIS has now been expanded across the state with over 85 000 active enrolees, paying only approximately USD $2.50 per person, per year, in insurance premiums to receive excellent coverage all-year long.

Considering that approximately 70% of Nigerians live below the poverty line on less than USD $1 a day, subsidised health insurance can be the difference between life and death for a number of families. Out-of-pocket financing at the point of service in hospitals can cripple families financially for years, resulting in further economic vulnerability and limited access to regular primary healthcare, setting off a cycle of poverty and poor health for generations.

Learning from the success of this scheme, WBFA has decided to transform and merge our existing health financing schemes to initiate the Alaafia Universal Health Coverage Scheme (AUHCS) in partnership with Hygeia Community Health Care - a local health insurance provider - and PharmAccess Foundation. Through the AUHCS, we will fund the insurance premiums of 4800 people each year. Recipients will include pregnant women, children under five, adolescents, people living with HIV and AIDS, and the elderly, in line with the guiding principles of universal health coverage.

We established the AUHCS with women in mind, as adolescent girls and pregnant women will represent 50% of our AUHCS recipients. This will allow women and girls to access better primary healthcare at the most vulnerable junctures of their lives, rather than relying primarily on emergency care. Consequently, this will result in better overall health habits, healthier home practices, and improved community-based care. Research has shown that investing in reproductive, maternal, newborn, child and adolescent health (RMNCAH) could yield up to nine times its value in economic and social benefits, and healthy home practices and community-based care could save over 90 000 babies a year. Primary healthcare over emergency care not only avoids high out-of-pocket spending, but also educates mothers about their health and the health of their children. This will empower women to make informed decisions about their care, in partnership with their healthcare provider, setting the foundation for respectful maternity care and improved long-term relationships with healthcare professionals. Establishing a relationship of respect and trust with healthcare professionals during adolescence will also encourage young girls to overcome cultural stigmas regarding their reproductive health, and engage in health-seeking behaviour throughout their lives for the benefit of their entire families.

I am pleased to announce the launch of the AUHCS on International Women's Day as women's empowerment is intrinsically linked to health. Affordable health insurance puts women in control of their health. Control over their reproductive and maternal health gives women control over the course of their lives. It gives them the power to make life-saving health decisions for their families, the power to demand respectful maternity care, and the power to develop long-term relationships with healthcare providers. The impact that this will have on every woman, and every child, and every community will be felt across the world. Let's picture it!