Sambo: Singing a welcome song at NHIS

President Muhammadu Buhari’s vision for a functional health care system where all Nigerians are reached irrespective of financial status is best captured by the National Health Insurance Scheme (NHIS). In the last couple of years, however, the high hopes of the President to translate such a vision into practical benefits for Nigerians have been caught […]

President Muhammadu Buhari’s vision for a functional health care system where all Nigerians are reached irrespective of financial status is best captured by the National Health Insurance Scheme (NHIS). In the last couple of years, however, the high hopes of the President to translate such a vision into practical benefits for Nigerians have been caught in the mesh of operational challenges and leadership crises of confidence at the Scheme.

The Federal Government had lofty dreams when it established the National Health Insurance Scheme (NHIS) by Act 35 of 1999. The NHIS was set up with the mandate to ensure universal access to good health care services, by protecting families from financial barriers to health care, and ensuring availability of funds to the health sector for improved services.

At the time of establishment of NHIS, the World Health Organisation (WHO) ranked Nigeria at 197 out of 200 nations. Life expectancy at the time for the Nigerian male was 48 and female 50 while healthy life expectancy (HALE) for both sexes was put at 42. The picture did not look quite cheery.

It was in the face of this dismal health situation that the NHIS was launched on June 6, 2005 with commencement of enrolment starting in September the same year. As at 2012, over 4 million identity cards had been issued, 62 HMOs accredited and registered. There were 5,949 Healthcare Providers, 24 Banks, 5 Insurance Companies and 3 Insurance Brokers accredited. These figures have experienced some improvement but, the nation is far from where it ought to be in affordable and qualitative healthcare delivery.

The above scenario showed that by 2012, only about 3 per cent of the country’s population was reached by the NHIS programme. The task before the Scheme is certainly herculean. And when it seems that experience should work in the advantage of the country, what was recorded were crises and a tainted image brought about by corruption allegations and a questionable leadership that left many questioning the place of hierarchy in public service.

Thus, for the last two years or so, the name NHIS conjures in the public’s eye a picture of an agency in need of direction and redemption, with a battered image, an uninspired workforce, unmet medical expectations and a disappointed public. But that was before President Buhari named Prof. Sambo as the new Executive Secretary and Chief Executive Officer of the NHIS.

Thus, the burden of restoring the NHIS to the path of glory fell on the laps of Prof. Mohammed Nasir Sambo, the nation’s only Professor of health policy and management with special interest in health care financing. An alumnus of World Bank Institute in Health Sector Reform and Sustainable Financing, reputed for his gifted capacity to turn around ailing institutions, Professor Sambo was seconded to Kaduna State University as the Provost College of Medicine on rescue mission of the near collapsed Medical College which he turned around within one year.

On his assumption of office on July 15, around 100 days ago, Professor Sambo who is not new to challenges and is not given to frivolities, reeled out his 3-Point Agenda aimed at turning around the fortunes of the NHIS which image has come under intense criticism before now. These three pivots include:

Restoring a Value System that will transform NHIS into a credible result-driven organisation.

To achieve this aspect, the new Executive Secretary understands that, good work ethics, unity of purpose and direction, synergy between the NHIS and collaboration with critical stakeholders are essential elements that must be restored, as quickly as possible.

The second aspect of the 3-Point agenda is Engendering Transparency and Accountability in the entire operations of the Scheme

Perhaps, this singular item has been at the bedrock of the myriad problems that the NHIS has suffered in the last couple of years. Prof. Sambo therefore announced that for transparency to thrive as the guiding principle of the NHIS, openness in the Scheme’s operations cannot be compromised; this can only be accomplished through evidence-based working system.

And thirdly, Accelerating the drive towards achieving universal access to quality healthcare for all Nigerians.

As an insider who has been in the forefront of the establishment of effective national health management programmes, Prof. Sambo was the First Zonal Coordinator, South West zone of NHIS, the first National Coordinator of Community-based Social Health Insurance that developed the 6-pilot community-based Social Health Insurance Programmes and the former Head of Health Maintenance Organisations that registered the first 5 HMOs in the country.

To achieve any meaningful result, Professor Sambo realises that only an NHIS which puts the well-being of the people of Nigeria uppermost is worth pursuing. He did not mince words when he announced this objective to the staff of NHIS from the first day.

At that inaugural meeting with staff, he made an individual promise as the new Executive Secretary of the NHIS, going forward, to do his best to return the lost glory of the organisation, with a clear objective to reposition the scheme and make it realise its core mandate for the purpose of national development.

Undaunted and determined to live up to the expectations of President Buhari, who must have appointed him based on the confidence he has that this 51 year old academic with specialty in this area, will not let Nigerians down, Prof. Sambo has move far and wide, nationally and internationally, and has within just three months in office, has touch more places and delivered more results that the Scheme might have achieved in three years, and his good works have suddenly obliterated the negative image of the Scheme and instead now places the NHIS in a good stead to enjoy public confidence.

For instance, among his first major tasks on assuming office was the speedy launch of the Basic Healthcare Provision Fund in the Federal Capital Territory (FCT) which has the advantage of improving the well-being of inhabitants of the FCT and its surrounding communities.

He has continued to engage with stakeholders and state ministries of health and coordinating agencies since assumption office. Abia, Delta, Kano states, and the FCT have felt the charm of Sambo.

Just 10 days of his assumption of office, Prof. Sambo lost his dear wife of 21 years; hard a blow as that was it was not strong enough to derail the university don from the work at hand; this is because of the determination to deliver on the promise of President Buhari on health to Nigerians. His strength of character saw him overcome this temporary setback in just days.

A man with intense mental and physical capacity, Professor Sambo’s field work across diverse areas of health service in Nigeria is an assurance that the future is a bright one for the NHIS. In 2005, he undertook a study on the Assessment of Social Health Insurance in Nigeria, sponsored by WHO and in the same year, NACA, British Council and the World Bank sponsored him to carry out a National Mapping of Family Life HIV/AIDs Education Curriculum; later in 2010, he conducted a National Survey on Vulnerability and Response to HIV/AIDS in Nigerian Prison Service, he understands the community health challenge of the country.

The future of Nigeria’s health service delivery has certainly found an assured hope of success in Professor Mohammed Nasir Sambo.

Obuns Solomon, of Media Digest, wrote from Abuja