The National Health Insurance Scheme (NHIS), according to pharmacists working under the aegis of the Association of Community Pharmacists of Nigeria (ACPN), has been accused of continuously deviating from the aims, targets, and objectives of a well-coordinated Social Health Insurance agenda.
The National Health Insurance Authority, NHIS Act was passed in order to make it easier for people to access effective, affordable, and accessible healthcare. The pharmacists who claimed that the NHIS operational modalities were to blame for the unacceptable and disappointing coverage rate of less than 5% for over 15 years recalled that the unproductive Health Service Delivery System forced the enactment of the NHIS Act.
The ACPN praised the repeal of the NHIS Act in a statement during its 41st Annual National Scientific Conference in Lagos, which was titled: "Never Waste A Crisis: Community Pharmacists Learning For Future Preparedness."
The communique, which was co-signed by Pharm. Adewale Oladigbolu, National Chairman of the ACPN, and Pharm. Ezeh Ambrose Sunday, National Secretary, observed that NHIA 2022 was implemented primarily to promote, integrate, and regulate all health insurance systems in Nigeria.
“The goal of reducing out-of-pocket expenditure on health to less than 30 per cent will be easily achieved and, expanding health coverage will favourably cause a decline in Maternal Mortality Rate (MMR) and Under 5 Mortality Rate (U5MR).”
Stating that the role of community pharmacists in ensuring the delivery of quality healthcare services to the Nigerian populace has become more crucial than ever, they implored the government at the State and Federal levels as well as the private sector to utilise the depth of knowledge as well as broad spectrum skills of pharmacists in all key health programmes.
Further, they called on President Muhammadu Buhari to immediately give assent to the PCN Bill in the ultimate public interest.
The ACPN submitted that particular attention is paid to the shortcomings of the NHIS which could limit the success of the NHIA Act such as sidetracking of community pharmacists and other secondary providers in the Global capitation payment which adversely affected trust.
“Thus, payment mechanisms must be right and premised on the lawful precept which prescribes fee for service for CPs and other Secondary as well as Tertiary providers.
“Sub-optimal tariff management under NHIS, though entrenched in the New Act, however, calls for review of drug prices every three years which is too long and impractical due to the rate of inflation in frequency and proportion, capacity Development; a need for reawakening and continuing education of the different cadres of Health Practitioners. The engagement of licensed Actuaries, who monitor the implementation of the operational guidelines, ensuring equity (in fees for service, distribution of enrollees to providers, effective tariff management amongst other things) and proper risk management for all parties involved, is fundamental to effective implementation of this new NHIA Act of 2022, as provided for, in section 38 of the Act.
They further lamented that the supply chain system for drug distribution in Nigeria was faulty and ACPN had started a supply chain platform that interconnects all pharmaceutical entities in Nigeria.
They explained that the Premises to Premises or Pharmacy to Pharmacy (P2P) platform is a Pharmaceutical Ecosystem to make sure medicines ordered in Nigeria are from, and through PCN-registered facilities only, adding that the P2P platform was now operational to strengthen the supply chain system, reduce the prevalence of fake medicines and reduce the scare concerns associated with the industry.
The pharmacists maintained that no matter the illness, drugs are the last resort of disease, hence, the need for proper use of drugs, in the right combination, quantity, frequency, with a suitable diet, liquids and through the proper route.
They also pledged to commission a unique labelling model for Community Pharmacists to distinguish professional handling of medications with regards to appropriate counselling, medications review (MTM), and instruction.
They also recognised the importance of creating a scientific database of herbal products for primary health indications and called for a policy reform towards greater incorporation of herbal medicines in healthcare delivery as well as the identification of Community Pharmacists as care providers for substance use disorders and mental health screening.