Improving Pharmacy Services within National Health Insurance Scheme for better performance
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Abstract
Background: Following many attempts at implementing policy strategy on health insurance since 1960, NHIS was eventually launched in 2005. It has a mandate for universal health coverage for Nigeria. The important roles of pharmacies are discernible in NHIS statutory objectives, though the NHIS operation is largely to the exclusion of Pharmacists Council of Nigeria (PCN)-licensed pharmacies.
Objectives: This review was carried out to create an awareness about the exclusion of pharmacists and the pharmacy profession in NHIS operations, and to recommend practical solutions.
Method: We conducted a review of relevant literature on health financing and provider payment mechanisms, in addition to NHIS and PCN documents relevant to NHIS operations.
Results: The healthcare financing function of strategic purchasing, and the closely related provider payment mechanisms are well defined in NHIS documents. NHIS adopts global capitation among other provider payment mechanisms, to control costs. The implementation is evolving and could benefit from periodic evaluation of NHIS payment methods. Other identified implementation gaps include the exclusion of pharmacies as legal entities and other health professionals.
Conclusion: The adoption of global capitation, and the consequent exclusion of some healthcare providers, can be seen to be detrimental to NHIS' overall performance, and enrolees' satisfaction. For improved performance, recommendations include - re-designing NHIS provider payment system by contextualising lessons from countries like the Kyrgyz Republic; harnessing the expertise of all health professionals including licensed pharmacies; Also, PCN needs to craft professional development strategy to hone pharmacists' prerequisite skills for providing pharmaceutical care which Nigerians direly need.
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References
Onoka CA, Hanson K, Hanefeld J (2015) Towards universal coverage: a policy analysis of the development of the National Health Insurance Scheme in Nigeria. Health Policy and Planning 2015;30:1105-1117 doi:10.1093/heapol/czu116
WHO (2000) World Health Report 2000 Health Systems: Improving Performance Available at https://www.who.int/whr/2000/en/whr00_en.pdf ?ua=1 Accessed 20 May, 2020
The World Bank. Health Expenditure Data: Nigeria.
Available at https://data.worldbank.org/indicator/SH.XPD.CHEX.PCCD?locations=NG Accessed 21 May, 2020
WHO (2005) Fifty-Eighth World Health Assembly A58/20 Provisional agenda item 13.16 7 Social Health Insurance, Sustainable Health Fnancing, Universal coverage and Social Health Insurance. Report by the Secretariat
Barnighausen T, Sauerborn R (2002) One Hundred and Eighteen Years of the German Health Insurance System: Are There Any Lessons for Middle- And LowIncome Countries? Social Science and Medicine.54 Issue10 Pg. 1559-87
FGN 1999 National Health Insurance Scheme Decree No 35 of 1999 (now Act 35 CAP N42 Laws of the Federation of Nigeria (LFN) 2004).
Nnamuchi O (2009) The Nigerian Social Health Insurance System and the Challenges of Access to Health Care: An Antidote or a White Elephant? Medicine and law · Vol. 28 (No. 1):125-166 · January 2009? Available at; https://www.researchgate.net/publication/200459930 Accessed 20 May, 2020
Cashin C ed. (2015) Assessing Health Provider Payment Systems: A Practical Guide for Countries Moving Toward Universal Health Coverage. Joint Learning Network for Universal Health Coverage.
Alshreef A (2019) Provider Payment Mechanisms: Effective Policy Tools for Achieving Universal and Sustainable Healthcare Coverage DOI: Available at http://dx.doi.org/10.5772/intechopen.86840 Accessed 27 May, 2020
Barnum H, Kutzin J, Saxenian H (1995) Incentives and Provider Payment Methods. International Journal of Health Planning and Management · January 1995 DOI: 10.1002/hpm.4740100104
Langenbrunner JC, Cashin C, O'Dougherty S eds. (2009) Designing and Implementing Health Care Provider Payment Systems How-To Manuals. Washington, D.C. World Bank and USAID.
NHIS (2012) National Health Insurance Scheme Operational Guidelines. October 2012
Guardian Newspaper (2007) To Be Effective, National Health Insurance Management Must be Overhauled, November 3, 2007 in Nnamuchi O (2009)7 The Nigerian Social Health Insurance System and the Challenges of Access to Health Care: An Antidote or a White Elephant? Medicine and law Vol.28 (No.1): Vol 125 - 166 · January 2009.
Boachie MK (2014) Healthcare Provider-Payment Mechanisms: A Review of Literature. Journal of Behavioural Economics, Finance, Entrepreneurship, Accounting and Transport, Vol. 2, No. 2, 41-46
Quinn K (2015) The 8 Basic Payment Methods in HealthCare; Annals of Internal Medicine August 2015 163:300-306. doi:10.7326/M14-2784
www.annals.org Accessed 20 May, 2020
Pharmacists Council of Nigeria (PCN) (2020) List of Licensed Pharmacists and Pharmaceutical Premises in 2019. Nigeria.
Muratov S and Waning B (2006) In : Langenbrunner JC, Cashin C, O'Dougherty S eds. (2009)11 Designing and Implementing Health Care Provider Payment Systems How-To Manuals. Washington, D.C. World Bank and USAID.
Okonta AJM, Okonta EO, Ofoegbu TC (2012) Barriers to Implementation of Pharmaceutical Care by Pharmacists in Nsukka and Enugu Metropolis of Enugu State. Journal of Basic and Clinical Pharmacy 3(2):295-8. March 2012 DOI: 10.4103/0976-105. 103823· Source: Pub Med https://www.researchgate.net/publication/262306 184 Accessed 20 May, 2020