By: Ike Philip Abiagom

In a strategic move towards bolstering healthcare accessibility in Delta State, the Director General (DG) of the Delta State Contributory Health Commission, Olorogun (Dr.) Isaac Akpoveta, has emphasized the Commission’s dedication to the M.O.R.E. Agenda of the Oborevwori Administration. Health they say is wealth and this is exactly what the Delta state governor, Rt. Hon. Sheriff Oborevwori, through the Chairman, High Chief Austin Obidi and Director General of the Delta State Contributory Health Commission, Olorogun (Dr.) Isaac Akpoveta, is bringing to bear in the life of every Deltan. For Akpoveta, all Deltans must have access to quality health care as such, health care must be accessible and affordable to all.  In this interview with our Grassroots Publishers online, the Director General of the Delta State Contributory Health Commission, spoke about the success stories of the commission and the efforts been put in place to making sure that health centres are created for rural dwellers. The renowned medical doctor, who took his time to explain how the commission is run, said, he would want to be remembered for making healthcare service available to all residents of Delta state particularly those in the very rural communities that has not had access to healthcare for a very long time among others. Excerpts: 

Sir, being an Insurance man having interest in the Medical field, my question is what has been the impact of various schemes in Delta State so far since you took over one year ago?

Let me go back a little, 2015, former Governor Senator Dr Ifeanyi Okowa, set up a Technical Working Committee to draw the Bill that became Law. I headed that Technical Working Committee and thereafter His Excellency was kind enough to appoint me the pioneer Chairman of the Commission and I was the Chairman of the Commission for two tenure before the dissolution in July last year.

We started from zero, we started from what we called a VISION. His Excellency had a vision that as he was campaigning round the state he could see in the people poverty from the nooks and crannies of Delta State. I was in that Campaign Committee. The vision was very clear to me that one of the factors that perpetuate poverty in the society is illness. If anyone of us here gets ill, not only that you can’t bring in more funds to the home, you will drain all the resources that you have to take care of the illness. And if it’s not available, you start selling the properties you have or your family property to get well, because everyone must struggle to get well. In the process poor people become poorer. And the only way you can probably reverse that is to give them Health Insurance. And that’s what His Excellency did. That vision was converted to visible structure that we have today and the visible system of Health Insurance. The Governor with his political goodwill and financial support, my humble self, the Director General, Dr. Ben Nkechika, put up that system that is first above all other systems in Nigeria. So, we have achieved a lot generally up to now; by one in every aspects of pillars of Health Insurance. There are eleven pillars but we’re No.1 in every one of them till today. Now, your question is since I took over 6-7 months ago, what has happened?

I think the present Governor being a system person who actually attended Insurance seminars before he became Governor, when he was Speaker, they were the ones that passed the Bill into Law. And I know he attended a lot of Insurance Conferences across the nation before he became Governor. And so, he realized that there’s need for continuity and sustainability of the Health sector in Health Insurance. And I was pleasantly surprised and happy that he appointed me the Director General. He said then, “Go and do what you know best to do”. And today I left and met an enrollee figure of about 1.7 million. Today we have 2 million plus enrollees in the past 6 months I took over. And what did I do differently?

I realized, after thorough assessment of my performance in the past seven years I re-assessed myself in the service of the Commission and I realized that the popularity of the Commission was low. The people are not aware of the activities of the Commission. I took it up, invited you guys to ensure that the people are aware of Health Insurance and the value of Health Insurance to everyone. And of course, I started some few initiatives, apart from the ones we’ve written before like the Indigent Enrollee Adoption Initiative, the Artisan Enrollee Inducement Initiative, the TISHIP – Tertiary Institution Health Insurance Programme – for students among others. And in particular the indigent enrollee adoption programme have gained ground. Because in that I made a clarion call to Deltans of Goodwill, Deltans of Oath, Philanthropists in the society to come to the aid of the vulnerable indigent people. Every one of us has a poor man in their homes. In Africa, you have one rich man and 90% of the family members are below par. Then, we need to go home and help them. I’m glad that the prominent Deltans have heed that call and have been adopting and paying for Health Insurance for our people. God Bless them.

Again, I also ensured that the system here is working very well, probably improved on the smooth running of the scheme, ensuring that whatever little money that we have is paid to the Providers, also talk to the Providers of Healthcare facilities to ensure good attention, go

od services to our enrollees. All these put together has increased the awareness of the scheme. People walk in these days and say “I want to register”. And we have registration centers in every local government, we have 300 agents round the state and of course, we have registration center in the headquarters here. And with all these put together we are moving faster. We were crawling before like a new baby of 7-8 years, now we’re moving faster and I’m sure very soon with the support of the Governor who is very interested in the Health Insurance, we would reach where we are supposed to be.

How has it impacted on the different demography across the state?

Let me explain what Contributory Health Insurance means. Contributory means that you need to pay a small amount of money as your contribution and the Government will support you. A Health Insurance organization is a finance organization. It’s not really a clear medical treatment organization. We pull resources together from government, individuals, philanthropists and donors into what we call the FUND and from there pay for services rendered. And I can tell you we pay huge amount of money in billions to hospitals across this country. And I’m happy to announce that many hospitals have improved their equipment status, their ambience. I know of a hospital that bought X-ray machine from the funds they received from us. They received over 30 million a month and after deducting cost of services they are forced to employ more doctors, buy equipment, renovate their environment among others. So, it’s impacting positively in the Health sector of Delta State.

Again, we have treated 1.7 million plus pregnant women and children U-5 over the last seven years and that has reduced the death rate of mothers and children U-5. Let me say something, when I was young you find out that the mother had eight (8) children and probably only two (2) will survive. But now if you make the mistake of having eight (8) children, the whole children will live with you and you will train them. Because the Health Insurance will ensure that they don’t die at the age of between 0-5 years. The notion that there is a witch in my family killing my children is gradually disappearing because all the children will be alive into adulthood. Thanks to the Governors of this state – Uduaghan, Okowa and Sheriff Oborevwori – who introduced the maternal and child care before we inherited in 2017 January. Delta State has one of the lowest U-5 death rate and death in pregnancy. So, it’s impacting very well in the state and I think very soon we’re going to do a research to re-value in terms of figure statistics of impact and you would see that we would likely to be No.1 of the state with lowest death rate at the level of U-5 and pregnant women during delivery.

This programme of indigent enrollee adoption is gaining a lot of ground. What do you have to say over the Artisans scheme?

The indigent enrollee adoption programme is gaining ground because Delta is the “Big Heart”. The word “Big Heart” means a Caring Heart, a loving Heart. And when you appeal to people properly, that they need to help and see the value of the money they’re spending by adding value to people’s lives, don’t be surprised that most people, including you, would buy Health Insurance policy. At the next Press Briefing we’re going to have every one of you tell me how many people you have bought for: 1 for N7000, 2 for N14000, 10 for N70000 – you can afford it. And that is gaining ground and I’m happy about that.

The Artisan Enrollee Inducement Programme – I used the word “Inducement”, the Artisan you know are people like the Okada riders, Barbers, Tailors, Market women at the low level, their fund inflow is peace meal and they feel very difficult to bring out N7000 to pay at once. So, we realized it would be very difficult and we have approached a lot of them, form them into groups and say “we will give you small loan to pay for your Insurance then you pay back at N100/day…meaning in 90 days (3 months) you would have paid off to the Bank that gave you the loan. We will guarantee that one. We have finished with the Bank and there are Banks who are ready to give us good money – Bank of Industry and Commercial Banks. In fact, it’s an investment for them because they know it is something that would bring a lot of money to them. Very soon it’s going to take off. But even at the moment about 40,000 Okada riders are already in the scheme, market women are into the scheme. But I want it to begin to blossom like the indigent enrollee programme. Meanwhile, why do I use the word inducement? Induce them to take a loan and pay for their Insurance, let them enjoy the care for a year. At the end of the one year they will realize that they don’t need to take a loan but can afford N7000. If you put your mind into anything you can do it. It’s when you are not too sure of what is going to be the return on your investment that you hesitate. But after one year of using this programme you will know that you can pay N7000. And I’ve bought insurance for people like that and after one year they don’t trouble me again, they pay for themselves. So, we’re inducing them to come in and  then we believe that at the end of the day the inducement would become a permanent thing and people would start buying insurance for themselves. Insurance is about renewal. When people renew, it’s then there’s sustainability. I’m very systematic in doing my things. When that one would hit the ground running you will be surprised that a lot of Artisans will key in. I go round town and I see a lot of people even at Shoprite that can afford N100/day. That’s where we’re going to and you need to publicize it very well and encourage people to go into it.

Most Civil Servants In The State Complained That When They Visit Hospitals, They Are Not Attended To As Expected And Many At Times, They Are Just Given Only Paracetamol, What Is Your Commission Doing About This.?

There are lots of tertiary institutions across the state with high students’ population and majority of these students come from outside the state. The TISHIP you are proposing will the programme cover them when they’re outside the state?

Very good! I think you are thinking like me and I’m happy to see that you are thinking in that direction. Actually, TISHIP is an old programme established by the Federal Government in 2014 but it failed because the packaging was poor. And when I reactivated it for Delta State, I studied it and came to realize that many factors are missing. A student stay half of the year in school and the other half at home. What happens to them after paying such money for insurance. So, I repackaged it and after meeting my colleagues and other CEOs of Health Insurance Schemes across the country, I told them that there is the need for cross utilization of Health Insurance in the country and they agreed with me. In fact, that issue has been confirmed and now there is inter-relationships between the Agencies across the country. What are we trying to do? A student pays for Health Insurance (Medical Fee) every year. That money is being transmitted to us, we return it by capitation for certain payment of the hospital in that center. That money is used first and foremost, to reactivate the primary healthcare center to become a Comprehensive Health Centre in the School. They would get money to employ Doctors to work there. For example, UniDel Agbor, they have about 8000-10000 students. And N4,800/student multiplied by 10,000 students, that’s over N4 million. They won’t spend more than a million naira and the balance goes back to activate the center.

Secondly, a student at home on holidays can receive treatment in any hospital in Delta State if he/she is in Delta. If he/she is in Lagos and a student in a school in Delta State, he/she takes the Health Insurance Card and go to a hospital that is under the scheme in Lagos State and a phone call is placed to us, we confirm you in our computer system, with that instantly we authorize for your treatment and the Bill is sent to us and we pay Lagos State hospital at their rate. If it’s Kano, Sokoto or Bayelsa, we all have agreed at our forum of CEOs of state Health Insurance Commission. In packaging it, I looked at it properly, met the Vice Chancellors and they saw the huge value in it.

As A Commission, What Are Some Of Your Challenges?

We pride ourselves with the fact that there is that ability to show that the health insurance scheme works. It is an evidence-based activity that we do. So, the biggest challenge that we have is convincing people that there is a possibility that this thing will be truthful. The next challenge is getting our healthcare workers to change their mindsets, they are used to get to work at 10:00am, close by 4:00pm. No, it has changed, you must come to work on the morning, close in the evening. Another challenge is that we need their mentality to change because before in our early days, the nurse or health worker was a king but the thing has changed, the customer is the king. Why? Because you have collected that person’s money upfront. So, changing that mentality of our healthcare providers where they think they are the king is very important, because customers are now kings. You must respect, treat them well because without the customer, you won’t be in employment. So, those are the challenges we are having, most of the other ones are things we can surmount, they are typical basic challenges. If we are able to change peoples’ mindsets and get our healthcare providers to change their orientation, 50 percent of our challenges would have been solved.

What Would You Like To Be Remembered For As The Pioneer Director General Of The Delta State Contributory Health Commission When You Finally Leave Office.?