‘How GoHealth is improving access to healthcare services in Gombe’

What informed the government’s decision to establish the Gombe State Contributory Healthcare Management Agency (GoHealth)?

It is part of the manifesto of Governor Muhammadu Inuwa Yahaya that, if elected into office, he would provide a mechanism to ensure that people are protected from financial hardship when they fall sick. And that’s exactly what he did when he assumed office in 2019.

So, the whole aim is to provide a mechanism for people to access quality healthcare services with minimal out-of-pocket expenditure, which is the global trend now.

Also, the Sustainable Development Goals (SDGs) 3 is about providing access to needed services without suffering financial hardship. So, what we are doing in Gombe is in line with that global goal of achieving Universal Health Coverage (UHC).

Can you highlight some of the conditions required by people to enrol?

Yes, the agency came up with three different programmes and we believe every resident of Gombe State can participate in one programme or the other.

We have the formal sector programme, which takes care of the needs of those who are in formal employment, be it government or some sort of private employment. 

But, we started with the state civil servants and we entered into negotiation with the organized labour and they agreed to participate in the programme.

We started deductions which we agreed upon at 3.5 per cent of their gross salaries, and we are still negotiating with the local government workers, as well as other categories of the formal sector that we believe can benefit under the formal sector arrangement.

So far, we have enrolled about 40,000 civil servants in the state and their families and they started accessing services on October 1 last year.

We also have the informal sector programme that takes care of artisans, businessmen and other groups of informal sector workers.

For some reason, we don’t register individuals in this programme; people must register as a group. At least six people should come together and pay a premium of N60,000 per annum to be granted access to the same services those in the formal category are enjoying. 

The third programme is what we call the equity programme, which is for the indigent population or the poorest of the poor including Persons Living With Disabilities (PLWDs) 

Also, we have an equity programme in Gombe State, where the government has earmarked 1% of its consolidated revenue and that of the LGAs as an equity fund, so as to take care of the medical needs of the poor and vulnerable.

What are the packages?

We have a very robust benefits package that takes care of not less than 80 to 85 per cent of the common ailments that affect the people of Gombe State. We didn’t just adopt a standardized benefit that is being applied at the national level. We contextualised our own. It was a rigorous process that we followed and we identified the common diseases that afflict our people and we designed the benefits package to address most of these cases.

 But I assure you that in the very near future, we are going to take a very bold step to cover even the services that are not covered at the national level. 

How difficult was it to convince people to enrol for the GoHealth in Gombe?

It was a tough process at first – like in any health insurance. Because for any health insurance to succeed you must have the formal sector on board; it is usually the backbone of any successful health insurance operation. 

 If you are not able to deduct the contribution at source, it will be very difficult for the programme to be successful. We set a target from the beginning, to engage with organised labour and convinced them to agree to participate in the programme.

Within three months of establishing the agency, they wrote to us, that they are ready to participate in the programme. That notwithstanding, we must give credit to Governor Yahaya, because one of the conditions the organised labour gave, was for the minimum wage to be implemented before they could agree to participate in the health insurance stuff. The governor accepted and started paying the minimum wage as far back as January 2020. 

What is the source of funding for the programme?

We have a number of sources; number one, we have the employer contribution. The government itself is also contributing 3.5 per cent of the consolidated salary of every worker as an employer contribution. We have the employee contribution, that is the 3.5 per cent that we are deducting from every worker’s salary and it also goes into the same pool. 

 We have funds from the Basic Healthcare Provision Fund (BHCPF) that are coming for the vulnerable and go to the same pool. We also have the little returns we are gaining from the investment that we have made and it is also going into that pool.

There are other sources of revenue for the scheme, such as grants and aids, either from philanthropists or donor agencies. We also have some little charges that we get from the healthcare providers.

Is the Gombe State government paying the counterpart fund?

The operational guidelines of the BHCPF require that for any state to participate in the programme, it must provide at least 25 per cent of counterpart funding. For every N100, the NHIA gave to the state for the implementation of the BHCPF, the state government provided 25 per cent as counterpart funding in order to cover more people under the programme. 

 And there is also the equity component. As I said, the state government is also giving. Overall, the state government plays a very significant role in the implementation of the BHCPF. And the government is up to date in the payment of its counterpart funding.

With the current financial crisis in the country, do you think the GoHealth programme is sustainable?

It is very sustainable because it is the people that are contributing to it as it is a contributory programme – it’s not 100 per cent funded by the government.

 What is the procedure for enrolling People Living With Disabilities (PLWDs), and the benefits?

The poor and vulnerable are a large group of people, who are in a socially disadvantaged position. They include the under-five children, aged population, PLWDs, Internally Displaced Persons (IDPs), pregnant women, widows and other categories. These people are usually given priority when we go for enrollment.

 We concluded the enrollment last Saturday and we are still doing data cleaning and we will be analyzing the data. No less than 25 per cent of our enrollees will be persons with disabilities and other categories of the needy in society.

So, the BHCPF and the equity programme have adequately captured PWDs and prioritised them during enrollment.

What is the total figure of enrollees for the programme?

For the formal sector programme, we have nearly 70,000 beneficiaries. The enrollment is ongoing and the numbers will keep increasing. For the equity programme, last year when we implemented the first phase of the BHCPF, we were able to take 25,000 poor and vulnerable people.

For this year, we are targeting to enrol at least 40,000 poor and vulnerable. During the exercise we conducted last week, we were able to identify over 100,000 potential beneficiaries. But our resources can only accommodate 40,000 for now, but as the state government releases equity funds, we will be adding the numbers.

 For the informal sector programme, which is the baby of the three programmes, we registered slightly over 1,000 people. If you put this in total, we have over 100,000 beneficiaries currently registered under the scheme.