Saturday, 30 May 2015

optometry.naija: National Health Insurance Scheme (NHIS), Universal...

optometry.naija: National Health Insurance Scheme (NHIS), Universal...: The National Health Bill 2014 referred to a:  "health care personnel" as health care providers and health workers;  "hea...

National Health Insurance Scheme (NHIS), Universal health coverage and the Nigerian Optometrist. Part 4.

The National Health Bill 2014 referred to a:

 "health care personnel" as health care providers and health workers;

 "health care provider" as a person providing health services under Act of Law;
[Section 64(c)]

 Laws of the Federation (1989) Chap. 09, No. 34 established the regulatory framework of the Optometrists in Nigeria, the ODORBN (Optometrist and Dispensing Opticians Board of Nigeria). This Act of Law automatically qualifies the Optometrist as a "health care provider" as posited above.

It is therefore important to note the inclusiveness of the Optometrist in the Health system of Nigeria.

In Part 2 of this blog, I pointed out this:

The National Health Insurance Scheme Operational Guidelines (2012) identifies the Optometrist thus:
2.2.13.1 Possession of Doctor of Optometry degree, or equivalent qualification recognized by optometrist and dispensing optician registration board of Nigeria (ODORBN)
2.2.13.2 Registration with ODORBN
2.2.13.3 Possession of current license to practice issued by ODORBN.
In pursuant to a proper representation and inclusiveness of Optometry in the health system of Nigeria it is very important to identify with these:

(4) The National Council shall have powers to regulate its proceedings.
(5)(1) The National Council which shall be the highest policy making body in Nigeria on matters relating to health, shall-

(c) ensure the delivery of basic health services to the people of Nigeria and prioritize other health services that may be provided within available resources;
[ National Health Bill 2014]

Basic health is defined as

 "basic minimum package" which means the set of health services as may be prescribed from time to time by the Minister after consultation with the National Council on Health; [Section 64]

The National Health Insurance Scheme is funded under the National Health Bill 2014 for:

"provision of basic minimum package of health services to citizens, in eligible primary/or secondary health care facilities" [Section 11(3)(a)]
And,
(5)(3) The National Council shall be advised by the Technical Committee established in terms of this Bill.

The " Technical Committee" means the committee formed by section 6;[Section 64]


The Technical Committee shall comprise - (Amongst others)

one representative each of all statutory health regulatory agencies or councils; 
[Section 6(2)(h)]

ODORBN is the statutory health regulatory body of the Nigerian Optometrists by law and is automatically a member of the Technical Committee based on the provision of Section 6(2)(h). It therefore behoves of us to consolidate our view points and stress our agendas using this channel.
ODORBN, with the blessing of the NOA, is expected and literally compelled to assume the responsibility of proper representation of the profession in relevant health issues like the NHIS, national health policy etc.

 It is a good head-start by Dr Damien Echendu's NOA (Nigerian Optometric Association) presidency to have inaugurated the Political Action Committee (PAC) with an instruction to explore NHIS and other relevant issues. I hope the recommendations they (PAC) came up with will be appropriately looked into with the view of forming opinions to be discussed at the Technical Committee meetings. Another laudable and bold step is the town-hall meeting that was organized recently in Owerri, first of its kind since 1968! This type of town-hall meeting should be held in all 36 states of the country and in Abuja periodically to hear our version of the Optometry story and act as a melting pot in our quest for growth and development!

 Finally, on the 24th of December, Dr.Anene Chukwuemeka, the secretary of the PAC, released some recommendations by the committee. I will only highlight one of those recommendations, to wit,

"We also recommend that a letter be written to all relevant parastatals and agencies associated with health and more especially ocular health such as National health insurance scheme, National primary health care development agency etc. This is necessary and will open up channels of communication between the association and these agencies which will be utilized when the need arises."

I will add that we should seek legislative interpretations of the relevant laws guiding the operation of NHIS in Nigeria with a view to appreciating the role of the Nigerian Optometrist as an Eye care service provider, nay, as an independent primary eyecare provider.

It will be laudable and appreciated if the newly appointed ODORBN registrar, Prof. Mrs Uzodike, and The NOA President, Dr Damien Echendu, will become allies for the common good of the profession especially as it pertains to National Health Insurance Scheme in Nigeria. For  starters, we need to have eye clinics that meet the minimum requirements on the NHIS operational guidelines for Optometry (See Section 2.7.9. of the 2012 NHIS Operational Guidelines) and become registered as a Primary care Provider under the NHIS.

This is the first line to "... open up channels of communication..." between the Optometrists, the Health Maintenance Organizations (HMO) and the citizenry.
The ODORBN should be responsible for "advising" The National Council of Health in Nigeria. They should play that role, as well as their traditional "dues" collecting role and other responsibilities as contained in the Act of Law that brought it to existence. On the other hand, the NOA should play the advocacy role, it should even lobby to ensure that ODORBN is heard at the technical committee meetings! NOA should seek the invocation of existing legislative premises that support our collective aspirations and even encourage review of our existing "scope" of participation in health care practice in Nigeria in a bid to align with the goals of the NHIS.
With the burden of blindness and visual handicap astronomical among the poor, the NHIS will surely ameliorate the sufferings of the masses and help in facilitating the objectives of vision 2020.

Long Live Optometry in Nigeria.
Long Live the Federal Republic of Nigeria.