Health insurance is for everybody – Dr. Yahaya Baba Adamu

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The new Medical Director of Federal Medical Centre Keffi, Dr. Yahaya Baba Adamu spoke to newsmen about how everybody can benefit from the NHIS. He also spoke on other issues about the institution. Excerpts;

 

May we meet you officially, sir?

 

I am Dr. Adamu Yahaya Baba, the medical Director of the Federal Medical Centre, Keffi Nasarawa State. I assumed office barely 3 months ago. I have been in charge of this institution, which mandate exactly is to provide care, research and also lead in giving tertiary health care service in the state and its surrounding.

This hospital happens to have a research unit that helps to look into daily activities of what is going on the hospital to come up with scientific studies and give us advice on some of the things / issues within the hospital.

Very few hospitals have these things. We are involved in taking care of emergencies and accidents as they occur. And being the only tertiary hospital within this area (outside Abuja) we are the succor from Makurdi and if you leave Jos the only place you will get such facility is here. And most of the people, even from Kaduna State it is closer to Keffi (the Southern part of Kaduna) than to go to the main Kaduna capital, where they belong.

Health has no boundary and accident has no timing. So even those who are traveling from the eastern part of the country when I mean east, both south and north, they come most of the time through Keffi when they have to go to Abuja. And God forbid if any, of them is involved in an accident, the only recourse we have is the federal Medical Centre Keffi.

Part of what I inherited is gap in the emergency care service which is what we are working on and because the government is particularly interested in health they have opened a window of providing interventions which we hope to probably catch in to make sure we develop a standard emergency care in the next couple of months. So that for any reason if anybody needs emergency care the hold up in Mararaba should not kill the person before he gets to Abuja which is the closest, after Keffi. And I see that as my very very important vision and mandate to make sure that care is provided beyond Mararaba.

And of course critical care is something that is very very scarce in the country as a whole which the government has decided to take the bull by the horn. I know the ministry has created a department of emergency and critical care. And because it is also part of my vision we are going to work closely with them to make sure that we develop a critical care unit.  Though we have a place like that we are going to equip it properly and train staff that can properly manage that, because even if you have the best facility and do not have manpower who is at home with the use of those facilities it will end up either being used wrongly or not used at all.

And the most important thing is to get facilities that you have manpower that can use them.

So part of what we are working at right now is to make sure we develop that critical care and make sure our staff are also well  trained in that respect. And even now and next week I have already engaged somebody who may come around because when you start using machine you expect that it may break down. So our in house bio-medical engineers are in the house to undergo a kind of training and maintenance on some of those things at least for regular maintenance. We do not have to stop and be looking for someone who will come in from Lagos, Kano or Port-Harcourt wherever they will stay.

So we are focusing on maintenance – preventive maintenance, routine maintenance, directive maintenance as well. To make sure even when we set up these things they don’t go out of service because one small thing or the other has happened. And of course the only thing again is to develop our obstetrics care and child care.

Recently we just rehabilitated our special baby care unit which is just like emergency care unit for children who are less than a month old. This is where you see very little babies who are probably less than two kilograms, 1.5KG and sometimes less than on kilogram, that are being cared for.

We have done a lot to see government help. I think we can even do better.

We want to fix our oxygen plant and make sure everything is going to be piped like you have pipe-born water. We have to pipe oxygen going round all those critical areas and the theaters as well. That is part of the things we want to do. At least we have a special baby care unit which is doing very well.

Many children have really benefitted from that. So as far as that is concerned that will reduce childhood mortality as much as possible, as more children will be saved as such facilities are available at a low cost, because we are rural / urban city. We are close to Abuja and I want to call us “urban” in quote, but we are actually rural.

The amount that is being charged will make possible for a lot of patients to afford. In short some of them who can’t afford Abuja service will even leave Abuja and come here. So we are not only serving Nasarawa State, we have patients coming in from FCT to come and access our special baby care service. And we are also working to improve the service we offer in our special service care so that we can also reduce maternal mortality.

Just this morning I had a meeting with head of obstetric and gynecology and we were discussing on giving them some kind of semi-autonomy so that they will be able to have most of the basic consumables they need under direct control. So that we do not curb somebody’s needs in an emergency cesarean session and the excuse will be no this, no that and eventually the baby dies for one reason or the other. We have some kind of liberalization of activities within the unit.

We actually have several units in the hospital; going forward we want to bring in when our critical and emergency services are well in place. We hope to bring in a higher level of tertiary care that are already not existing here, like neurosurgery and cardiothoracic surgery (hearth and chest surgery) and neuro is brain. So, because most of these patients when you operate on them, they need critical care after surgery and their recovering period.

So if you do not have an advanced critical care you may not be in the best position to start utilizing that kind of service.

We are on course and focused. The fact that I am a trained neuro- cardiothoracic surgeon, I know the importance of critical care and God’s willing I am going to be focused on that to make sure we have a very well developed critical and emergency care. And then we can advance to doing such sophisticated operations that involve the brain, chest and heart along with all the other operations we are already doing ground.

So in essence I am not sure I can address everything in one question.

 

What do you identify as major challenge since you assumed office?

 

Incidentally Keffi is not in isolation in the area of health challenge we have as a nation. Yes we always see it as infectious diseases as our major problem, but the reality is that one of our greatest problems as a nation in almost every hospital we continue to have emergency. People have accidents, domestic and road traffic accidents. Some of the great challenges we have is that people come in with head injuries, broken hands, broken chest, so many things like that. They keep coming and of course that does not stop us from being a developing nation. We still come up with infections problems – people come in with malaria fever, some respiratory tract infections. And of course it takes us also to another level.

We are probably not too lucky as a people because we are not so developed because we are still carrying the problem of under development. And then we are developed on another hand, because in the global world we have learnt to live the life of the developed world. So we also have imbibed the problem of the developed world. So even the so called modern diseases so to say, we are also sharing our part in it. We have our good share in stokes, we have a good share of heart attacks. And this used to be thought as things that are common to the western or developed world, but it is no longer the some because we eat fast food the way they eat.

We don’t want to exercise much anymore because we all have cars. We all have motor bikes. We don’t want to exercise any more.

People want to drive and enter right into their couch and trek the remaining three meters into their rooms or into their offices. And after work we stay all the way till evening and by the time we go home we say we are tired. And because we are tired we just stay on the couch and start watching television or go to sleep. So, all these things are risk factors; for us to develop the so called modern diseases.

So now we have combined both. If you look back in those days you may be suffering only from infectious diseases because when our parents have to go to farm they may trek three, four, five, six Kilo meters to the farm.

And when they reach the farm, they will use their hands to hold the hoe and spend all the energy of all those food they eat and burn it up. So they may not be faced with those are diseases with incident life style. Of course they have their own which was and is still what we are carrying on.

We have not dropped that. We have imbibed the new one and added to it. So these are some of the challenges and if we are developing we must carry primary health care, secondary health care and tertiary health care because all these are mixed up in one pot.

We continue to have various colors of all this coming to see up. So you can now see why I cannot tell us because we are rural let us focus on primary health care.

 

How many universities or institutions are making use of your facilities?

 

Practically we seem to be the major point of call for people, and universities have what they call university health center, but they do just basic things.

Recently I received the body of student union that came visiting and I was just telling them they could come and key into the federal government national health insurance scheme.

There is something that is community based social health insurance that is supposed to help such class of people who may not be able to afford cost expensive thing. But government is helping, that is why government has created such insurance scheme.

So if they register in, even though they are in school, just paying eighteen thousand naira (N18,000) per annum, the government will help to cover the rest, which is kudos to the government for coming up with such a thing.

So it is now creating more access to others who otherwise may not have been able to afford the services. So we are hoping to even extend this campaign to the community, not just the university or the other health institutions, government institutions that are around the hospital; so that eventually more people can come in.

We have a school of health technology that is directly behind us here. They are taking advantage of our presence and they bring in their students for training. It goes beyond school of health technology. I can tell you, as I sit here I receive letters from students from as far as Imo state, from Kaduna state, from Benue state, they are all coming here to be trained to provide service. So we receive them for their internship. Some of them are coming not just for internship, student work experience – industrial work experience scheme. They all come here, and of course this is a tertiary centre. We are also a centre of training for the doctors – the programme we call the residency programme. We train doctors to become specialists. And when they are trained, they move to other hospitals to serve. And those that we need their services we keep them.

So we are like some kind of production centre where we produce people who go round.

The issue of National Health Insurance is very import. How are you managing the scheme?

Thank you very much, the challenge is largely due to lack of information. Keffi people have been here, the hospital has been here, the insurance scheme has been here. But I was amazed when I mentioned it to Keffi Development Foundation {which is one of the pressure groups in the town. When they came to see me (when you were just waiting to see me)}, to see on their faces that such scheme was sounding new to them that such facility exists under the National Health Insurance Scheme as community based social health insurance.

They don’t even seem to know that such thing existed. So I think as journalists you people have a lot to do because the government has created this platform. It is not your primary responsibility somebody has such responsibility, the HMO (Health Maintenance Organizations). They are supposed to be the midwives between the regulatory body i.e. NHIS and the people. They are supposed to go and campaign to the people, tell them come and key into those programme.

I am as an institution who is concerned with rendering service and making the service accessible to the community I am supposed to be serving. I have to take it up and invite those HMOs and we select those of them who are very keen and serious to work with us. And they will get into the community and get people to get registered and be enrolled into the national health insurance scheme programme.

Because it looks like to many people this is just something that is meant for government workers. And this is not actually the way it should be. We would have gone beyond this if the campaign is going far and wide. So we hope that by engaging the HMOs that are working with us, we will be able to reach out to the wider community to ensure that they key into the very laudable programme the government has already come up with. So that more of our people will be able to afford.

I can assure you that for secondary and to some extent tertiary health care; all that is required from the community, just fifteen thousand naira per head per annum so if you pay the premium of fifteen thousand naira per annum you should be able to access basic daily health care you need. That is all the workers pay. Why not the community registering into it?

And the government went further low down to those who are attending primary health care. Of course there are Nigerians who may not have money for basic three square meal; but to pay one thousand eight hundred naira per annum, I am not sure it is too expensive for any group of people.  We are not saying per month; one thousand eight hundred naira per annum.

And that exist in the National Health Insurance Scheme for primary health care.

So for those of people who are living in core rural areas, they can access this by social insurance in the community where they come up to organize themselves into a group, they are captured within their villages. If they have issues, they run to the primary health care centre; they are taken care of, just because they pay one thousand eight hundred naira for one whole year.

 

How do you intend to tackle one or two problems you inherited from your predecessor?

 

You can’t inherit anything from anybody that he has left because the institution is an institution. I will also leave it again and somebody has to carry on from there. The institution is there for us to serve. May be what I am seeing today, because it is a continuous thing is a roll over.

That CC scan I was giving example earlier on was working. I hope you understand. And if it develops a fault and stops working I won’t see it as the fault of the last person because in the first place he brought it in and it was working, and then it failed. And now I came in I saw it and say let me fix this machine. Everything is a process. Now for the last six weeks I am on it.

They came found out the first problem. They fixed, and then they discovered another one. You can now see how these things happen.

We are working to fix the new problem they have found so that the machine will come to function. I don’t know what the problem was that kept the machine not working for like two or three months before I took over but now that I have taken over I can also see that there are certain challenges on the road that ordinarily you may not see, except an insider. So are the things that can happen in any place. Just like we are human beings we always have priorities for everything we do.

By the nature of his training, his exposures and specialization he may have his own focus, but all in the interest of the association. And then I come in too. I have my own specialization, my own focus and my own experience. So my priority will also be in another direction. But what is important is if all of us have the direction we are moving, at the end of the day it will coalesce and become in the best interest of the hospital.

Frankly I took over from the person that left with I an interesting enviable electronic medical record service that almost every government hospital in the country is coming to learn from us.

Recently I received the Ebonyi State University Teaching Hospital, that is Federal Teaching Hospital Abakaliki. The team; board and management came to my office, I had to bring extra chairs to accommodate them. And why did they come? They heard about how the electronic medical records have been performing effectively.

They came to key in and learn, so that they can implement the same thing. I think that sounds like something that one should feel encouraged about. So I am hoping too that during my own time I will create things that people will wonder how it works. Let’s go to Keffi and learn.

So instead of looking at the ones he didn’t do I have decided not to think about the one he didn’t do, but the one he has done. And which one will I also bring in so that just as people have to come to learn from, I am also aware that our SERVICOM department has been winning awards over time because of the way we run our things.

So you see when you come, it is just like in any place.  If you are interested in any relationship, if you are interested in seeing your negative; I will have enough to see. And if interested in seeing your positive I will have enough to see.

But there is nobody who is so perfect that he doesn’t have both sides. So for me I want catch on the advantage of the good things I met. Then the ones that I felt were not filled up I create my own too so that when the next person comes he will see the good things I have left behind.

And then he or she will only stand on whatever stage we have gotten to.

 

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