Dr. Sola Akande, the Executive Secretary of Oyo State Health Insurance Agency (OYSHIA), recently on Parrot Xtra Hour Radio Show on Splash 105.5fm Ibadan, shared insights into the agency’s mission and progress. Established in 2015, OYSHIA aims to provide financial risk protection against huge medical bills and improve access to quality healthcare for all residents of Oyo State. Excerpts:
How did you become involved with OYSHIA, and what motivated you to take on this role?
It was out of passion. I was the Director of Planning, Research, and Statistics, and we added insurance as a desk office, a unit. It started dawning on me that there’s no government that can do all and give all that health requires, whether a government or a nation. We had this practical experience; we had about 748 healthcare centers, and we were tempted to renovate them because they had never been renovated. So, we said, let’s renovate, and we worked with the Ministry of Works and came up with a BOQ. To renovate a primary health center as of that time, about eight years ago, would cost about 30 million naira, just to renovate, not yet talking about putting equipment. I just said that there was no government that was going to do that because 30 million multiplied by 748 would be a whole fortune, and the government has a lot to do. So, I suppose therefore, that there must be a way that the people must participate in their own healthcare. That is what health insurance is, and that was when we started laying more emphasis on the health insurance desk we had at Planning Research and Statistics.
Can you describe the challenges you faced in implementing health insurance, particularly in terms of poverty, corruption, and bureaucracy?
The truth of the matter is that people have a poor understanding of insurance; the professors and the elites, well-read people know that insurance is a totally different kettle of fish. Again, the mentality of the people; I always say that poverty is not about whether you have money in your pocket or not, poverty is a mentality. There are rich people who always behave like they are poor, and there are some poor people who behave like they’re rich; they have adjusted their lives to when money would come. So, we have that mentality of poverty which is entrenched in our society, and that is actually the main challenge.
How did OYSHIA initially start, and what strategies did you use to launch the programme?
Firstly, it was not about me; I had a conversation with the Commissioner of Health at that time. I told him, ‘Let’s go this route; I believe it would bring a change.’ As a matter of fact, I remember at a meeting I said, if insurance did not survive, then health would be dead, that was a bold pronouncement. Then we came up with a strategy on how we were going to start, something we had not done before. I said, let’s have a pilot, and that’s how we started with 11 local governments in Ibadan. We started by letting individuals bring some money, letting local governments bring some, so that we put the premium at 650. Individuals paid about 200, local governments paid 150 per individual, and the government paid 200 per every individual, and that is about 650.
What percentage of the population is currently covered by OYSHIA, and what are the challenges in achieving higher coverage?
Today, we have about 5% coverage in the society that has a deficit of knowledge on what health insurance is, where they have religious beliefs, Christians who would say ‘I reject it in Jesus’ name’, Muslims who would say something similar, and in a society where mandatory is not enforced. In climes where there is a very high coverage, health insurance is mandatory; even though the law here says it’s mandatory, but we haven’t gone into the phase of enforcement.
How do individuals enrol in OYSHIA, and what benefits does the programme offer?
With the stage we are at today, anyone that wants to join OYSHIA will pay ₦18,250, and if you pay the money once, you will be registered in the hospital of your choice. We have over 400 hospitals under this organization; you can choose a health center, general hospital, or private hospital. The insurance also covers operation fees; if you want to go and see a doctor for a complaint, be it an optician, a dentist, or even an ear doctor, it covers all of it.
How do you select and monitor hospitals participating in OYSHIA?
Any hospital that wants to join us would write a letter to us; we don’t go to meet them. When they write to us, we send professionals to go check out the hospitals. There are certain areas that would be assessed and scored; if they are doing well in most of these areas, we’d send them a notice that they would be working with us.
How has OYSHIA impacted the poor and vulnerable population in terms of healthcare access?
One of the latest testimonies is from one of our enrolees that had just gotten an open-heart surgery done. That surgery cost about 10 million naira in all; there’s no way she could have gotten that done if not for insurance. As of date, we have almost 150,000 poor on Oyo State health insurance, and that’s tremendous and remarkable. As I’m speaking to you, we are enrolling people living with disabilities—10,000 of them; we’ve done about 3,000.
How sustainable is OYSHIA if future governments do not continue to support it?
The adoption model, Governor Seyi Makinde did 4,500 from his own pocket; if he leaves office, he can still do that from his own pocket, that’s not Oyo State government money. We have people living abroad; there’s a particular pastor that did 500 from his own pocket. So, the adoption model is using your own resources to bring people you know into health insurance.
What advice will you want to give those considering joining OYSHIA?
To everyone listening to me today, join OYSHIA; every one of our desires to have good health will be fulfilled. Come and register with ₦18,250.
