National Health Insurance Scheme
National Health Insurances Scheme (NHIS), which provides social health insurance in Nigeria and requires that healthcare services of contributors are paid from the common pool of funds contributed by the participants of the scheme, took off in this hospital in 2006. The center is accredited for provision of both primary and secondary health care. The center also provides tertiary health care service to those needing referral to specialists in other fields of medicine.
NHIS GOALS/MANDATE/RESPONSIBILITIES
• Providing qualitative health care service to enrolees of NHIS.
• Adequately capture enrolees of the scheme.
• Prompt and appropriate documentation of referral cases to secondary care service provider and treatment of same.
• Sensitization of the hospital community/stakeholder of the scheme.
• Training and retraining of staff of the scheme.
STAFF STRENGTH
The NHIS unit is staffed with adequate compliment of clinical and non-clinical staff that ensures smooth operation of its services.
BENEFIT PACKAGE FOR ENROLEES
1. Out-patient care, including necessary consumables as in NHIS standard treatment guidelines and referral protocol.
2. Prescribed drugs, pharmaceutical care and diagnostic tests as contained in the NHIS drugs list and NHIS diagnostic test lists
3. Maternity (antenatal, delivery and postnatal) care for four pregnancies ending in live births under the NHIS for every insured enrolees in the formal sector programme. Additional care if any still birth.
4. All live births eligible to cover will be covered during the post-natal period of twelve (12) weeks from the date of delivery.
5. All preterm/premature babies eligible to cover shall be covered for twelve (12) weeks from the date of delivery.
6. Preventive care, including immunization, as it applies in the National Programme on Immunization, health and family planning education. Adult immunizations Viz: HPV, Hepatitis etc.
7. Consultation with specialists, such as physicians, paediatricians, obstetricians, gynaecologists, general surgeons, orthopaedic surgeons, ENT surgeons, dental surgeons, radiologists, psychiatrists, ophthalmologists, physiotherapists etc.
8. Hospital care in a standard ward for a stay limited to cumulative 21 days per year following referral.
9. Eye examination and care, the provision of low priced spectacles but excluding contact lenses.
10. A range of prostheses limited to prosthesis produced in Nigeria.
11. Dental care excluding those on the exclusion list.
12. Annual medical check-up unrelated to illness
SERVICES RENDERED UNDER PRIMARY HEALTHCARE LEVELS
1. Out-patient care (including consumables)
2. Routine immunization
3. Surgical procedures
4. Internal Medicine
5. HIV/AIDS management of opportunistic infections.
6. STIs
7. Mental Health
8. Paediatrics
9. Obstetrics and Gynaecology
10. Ophthalmology
11. Emergency care
12. Family Planning Education
13. Child welfare services
SERVICES RENDERED UNDER SECONDARY HEALTHCARE LEVEL
1. Surgical procedures
2. Internal Medicine
3. HIV/AIDS
4. Paediatrics
5. Obstetrics and Gynaecology
6. Ophthalmology
7. Ear, Nose and Throat (ENT)
8. Dental Health
9. Physiotherapy
10. Radiology/Ultra-Sonography
11. NHIS Antenatal policy
12. Ophthalmology
SERVICES RENDERED UNDER TERTIARY HEALTHCARE LEVEL
1. Surgical procedures
2. Internal Medicine
3. HIV/AIDS
4. Paediatrics
5. Obstetrics and Gynaecology