Kwara State Health Insurance Program named a finalist in OECD DAC Prize
The Kwara State Health Insurance Program has been recognized as a best practice model for taking innovation to scale by the Development Assistance Committee (DAC) of the OECD. This achievement was celebrated during an award ceremony held at OECD's headquarters in Paris on Tuesday, 7 October 2014. The Kwara program is a joint initiative of the Kwara State Government, Hygeia Community Health Care, the Health Insurance Fund and PharmAccess. The OECD praised the program's "comprehensive approach on the demand and supply side in establishing a working healthcare system, generating sustainability and overcoming market failure."
The OECD DAC Prize for Taking Development Innovation to Scale aims to support innovative programs that have gone beyond the pilot phase. The Kwara State Health Insurance Program, set up with the support of the Dutch government, was selected as one of the ten finalists for the first DAC Prize.
Charlotte Petri-Gornitzka, Director General of the Swedish International Development Cooperation Agency (SIDA), presents the award to His Excellency Abdulfatah Ahmed, Governor of Kwara State
The award ceremony took place during the OECD DAC's Senior Level Management Meeting, which was attended by all heads of delegation of OECD countries' ministries or agencies for international development. His Excellency Abdulfatah Ahmed (Governor of Kwara State), Senator Saraki (Governor of Kwara State when the program started) and Dr. Peju Adenusi (CEO of Hygeia Community Health Care) joined representatives from the Health Insurance Fund and PharmAccess in Paris for the occasion. In addition, the visit was an important opportunity to share information about the Kwara program, the initiatives of PharmAccess and the Health Insurance Fund, and to engage OECD for partnership building, funding and policy influence.
The OECD DAC Chair, Erik Solheim, hosted lunch for the Kwara Governor, Senator Saraki, the head of the OECD DAC Secretariat, the representative of the Dutch government and a small group of donors. Another meeting was held with policy/technical advisors of OECD to discuss programmatic co-operation between OECD DAC, Kwara State and the Health Insurance Fund and PharmAccess. In the afternoon, delegates participated in a forum discussion on public-private partnerships in healthcare delivery and attended the launch of the OECD DAC Development Cooperation Report 2014.
The OECD DAC award ceremony aimed to inspire and generate concrete actions to support further scale-up of the innovation. It was attended, among others, by heads of delegation, donors and officials of OECD countries, including the Dutch Deputy Director General for International Cooperation, Christiaan Rebergen. The Kwara Governor accepted the award on behalf of the partners in the program.
Charlotte Petri-Gornitzka, Director General of the Swedish International Development Cooperation Agency, presented the award and described the program as a "highly relevant and innovative public-private partnership for a health insurance system, improving health indicators in Kwara State by improving access to quality healthcare by pooling resources and improving clinics' access to capital."
In his speech, the Governor emphasized the unique partnership and relevance of the Kwara program implemented with Hygeia, PharmAccess and the Health Insurance Fund, the financial support of the Dutch Ministry of Foreign Affairs and his development policy for Kwara. He stressed the role of human capital and health in economic development and the investments that his government is making to ensure the success of the program. In the evening, the OECD held a dinner for the heads of delegation.
New Vision Forum
On 8th October, the Kwara Governor took part in a plenary session of an international conference, the 2014 Edition of the New World Forum at the OECD conference hall. Speaking on the theme, "Africa: the future is now," the governor discussed the need for innovative strategies to tackle the challenges of poverty and unemployment, conflicts, ignorance and disease and stressed some of the key initiatives in Kwara State, including education, agriculture, healthcare and entrepreneurship. Reactions from the participants and the media indicated the significance of Governor Ahmed's participation.
Kwara State Health Insurance Program
Through a public-private partnership that United Nations Secretary-General Ban Ki-moon described as ground-breaking and innovative, the Kwara State Government, Hygeia Community Health Care, the Health Insurance Fund and PharmAccess formed the Kwara State Community Health Insurance Program in 2007. This multi-dimensional program, set up with the support of the Dutch Ministry of Foreign Affairs, aims to improve access to affordable and quality healthcare for the people of rural Kwara. From the onset, it has been driven by committed support from Hygeia HMO (domestic health insurer), local politicians, religious leaders and communities.
The program has an economic approach to improving access to quality healthcare and aims to reduce risk and increase investment in healthcare in Africa. The Health Insurance Fund and PharmAccess mobilize public and private funds to increase clinical quality standards and facilitate access to loans for clinics, access to insurance and impact research. The Health Insurance Fund supported Hygeia by encouraging Dutch multinationals Shell and Unilever to insure their Nigerian staff through Hygeia's corporate program. The Investment Fund for Health in Africa, a private equity fund, invested in Hygeia Nigeria Limited in 2007, followed by FMO, IFC and Satya Capital.
The program addresses challenges on both the demand and the supply side of the health system:
- Improving access to health care by increasing investments in health facilities;
- Setting and raising quality standards for public and private health facilities. The development of SafeCare, a quality improvement program designed for resource-restricted healthcare facilities, has offered clinics positive incentives to move steadily upwards in quality and provided patients with insight into quality levels;
- Clinics have access to capital through the Medical Credit Fund, allowing them to invest in capacity and quality improvement;
- When quality improves, cross-subsidization and risk equalization in efficient state risk-pooling mechanisms can be introduced through health insurance. By subsidizing the premium, low-income groups gain access to insurance and healthcare;
The Kwara program has led to increased trust in the healthcare system and a heightened willingness to pre-pay for health insurance. By reducing risk and lowering transaction costs, the model has paved the way for private and public investments in medical, financial and administrative capacity. As such, the public-private partnership has built faith in a previously dysfunctional health system, bringing one Nigerian state closer to universal health coverage and providing a possible blueprint for others.
Currently, nearly 80,000 people are enrolled in the Kwara State Health Insurance program, the majority of which are women and children, contributing to the achievement of Millennium Development Goals 4 and 5. Both public and private health facilities have been renovated and upgraded, receiving over half a million patient visits since the beginning of the program. Healthcare utilization has doubled, whereby women account for over 67% of patient visits. There has been a 52% decline in out-of-pocket spending on healthcare. A recent study published in the prestigious Journal of the American Medical Association (JAMA), proved the positive impact of the scheme on the population’s health. Also, according to new World Bank data, Kwara has even climbed to be the second performing State in Nigeria with respect to maternal and child care.
Kwara State already pays 60% of the health insurance premium subsidy. Also, it has committed to take over the financial responsibility for the program and extend it to 60% of the rural population - i.e. 600,000 people - by 2018.
Chairman of the Health Insurance Fund, Kees Storm: "Together, we have created a successful public-private model, bringing quality healthcare within reach for people in one of the poorest states in Nigeria. Kwara State's commitment to taking over and expanding the program was an important milestone, proving the potential for scale. This recognition by the OECD DAC is a great honor, and we look forward to continuing the journey towards universal health coverage."
Press coverage of the event
- Senator Saraki congratulates Gov Ahmed on DAC Prize: http://www.abubakarbukolasaraki.com/senator-saraki-congratulates-gov-ahmed-dac-prize/
- Western Post / Global acclaim as Kwara wins OECD health innovation prize in Paris: http://www.westernpostnigeria.com/new/global-acclaim-as-kwara-wins-oecd-health-innovation-prize-in-paris/
- Nigerian Pilot / Kwara health insurance scheme wins OECD Prize: http://nigerianpilot.com/kwara-health-insurance-scheme-wins-oecd-prize/
- The Cable / Kwara community health insurance gets OECD award: http://www.thecable.ng/kwara-community-health-insurance-gets-oecd-award Daily Times Nigeria / Global Acclaim as Kwara Wins OECD Health Innovation Prize in Paris: http://www.dailytimes.com.ng/article/global-acclaim-kwara-wins-oecd-health-innovation-prize-paris/
- The Gazelle News / Kwara Governor Shortlisted for Award in Paris; Discusses Africa Development: http://www.thegazellenews.com/2014/10/08/kwara-governor-shortlisted-for-award-in-paris-discusses-africa-development-with-mo-ibrahim-others/
- Nigerian Tribune / Kwara wins health innovation prize in Paris: http://tribune.com.ng/news/news-headlines/item/18143-kwara-wins-health-innovation-prize-in-paris/18143-kwara-wins-health-innovation-prize-in-paris