EVOLVING A REALISTIC BASIC HEALTH CARE PACKAGE FOR OLDER PERSONS IN NIGERIA

Omini Oden

By signing the National Health Insurance Authority Act 2022, the Federal Government of Nigeria under the leadership of President Muhammadu Buhari has demonstrated the will and commitment to attain universal health coverage. The National Senior Citizens Centre (NSCC) commends the President and is carefully studying the NHIA Act 2022 and analyzing its implications for Senior citizens especially for most who constitute the sub-population category of the poor and vulnerable.

The National Senior Citizens Centre. is relieved by the inclusion of older persons “the aged” in the provisions of health insurance coverage as contained in the NHIA Act 2022. It indicates that these vulnerable older persons shall not be required to pay premium for coverage.

This category of the vulnerable as stipulated in the Act include under five, pregnant women and older persons referred to by the Act as “the aged”.  The vulnerable groups as listed are to access services within identified Basic Health Care Package.

The Director General of the National Senior Citizens Centre, Dr. Emem Omokaro, is however concerned about the chronic disease burden on older persons, peculiar to old age and also about the implications of coverage gaps, coverage appropriateness and equity.

What health care package would address basic care conditions and needs for older persons, peculiar to old age and if the present care package as constituted can actually address the objective of reliving vulnerable older persons from out of pocket expenditure on health care especially given NSCC’s quest to mainstream geriatric assessments and integrated care into Primary care system.

In a signed Memorandum of Understanding with the National Primary Health Care Development Agency, State Primary Health Care Development Agency Forum and World Health Organization, NSCC seeks to see the delivery of Integrated care for older persons beginning with;

i). Determining objectives and scope of baseline assessments in infrastructure, human resources and logistics to determine existing operations and systems that could be modified to respond to Geriatric care requirements and the needed interventions to fill the gaps.

II) To collate existing documentation of Geriatric care resources including sub- policies, strategic plans and curriculum, to determine what can be adopted, modified or gaps that must of necessity be filled towards promoting an inclusive National Primary Health Care Curriculum and Modules of Trainings for relevant categories of care personnel in geriatric care.

III) Mining or obtaining administrative data from Primary Health Care Facilities in FCT Abuja on older persons’ use of facilities? including disaggregated age range from 60 and above. frequency, location, distance to facilities, payment for services, other multi – indicators, which would inform decisions for running a   Pilot Integrated Care for older persons on two fronts in FCT;

i). the modification of existing facilities to Age-friendly Primary Health Care Facilities, and ii) Activating a Geriatric Home Care services eco-system by Community Health Extension Workers.

To this end, and taking advantage of the National Health Insurance Authority Act 2022, NSCC is gearing to engage National Health Insurance Authority on the possibility of evolving a realistic age specific Basic Health Care Package for older persons.

The National Senior Citizens Centre also seeks to engage Private Insurance companies in a Roundtable on designing innovative insurance coverage for NSCC flagship Care Agency Model of Care interventions for distressed family needing respite for long-term elder care and Basic Routine Home checks for their loved older persons.

The National Senior Citizens Centre is working hard with relevant partners to set the framework to develop Care Quality Assurance with regards to Care Agencies and Caregivers, to ensure benchmark standards. certification and monitoring and evaluation frameworks.

Development of these eco-systems are in process with the structured partnership technically supported by World Health Organization Nigeria.

Omini Oden (ACPA, FCAI) is the
Head, Corporate Affairs Media and Communication