Hygeia Community Health Plan evolved out of the aspirations of Hygeia Nigeria Limited and PharmAccess Foundation (A Dutch NGO) to scale up HIV and AIDS care in Africa. Both parties decided that HIV and AIDS care should be provided within an integrated healthcare delivery framework as opposed to the more prevalent vertical disease models. It was further conceptualised that this integrated healthcare delivery framework would best be sustained and maintained within the context of a health insurance scheme with subsidised premiums to facilitate the entry of individuals who were usually poor or had been impoverished by the disease.
This noble aspiration subsequently gave rise to Hygeia Community Health Plan: a demand-drive, donor subsidised community health insurance scheme for low to medium income populations of Nigeria. The scheme was launched in January 2007 and it commenced operations in February 2007. The HCHP is currently the local implementation partner of the Dutch Health Insurance Fund in Nigeria. The Fund has pledged funding for the co-premiums of 115,000 low income individuals over a period of 5 years. The HCHP is also working with the Fund, the World Bank and some state governments on extending coverage to more low income people.
Since the launch, the HCHP has enrolled thousands of low income individuals, commencing with pilot schemes for Shonga and environs in Kwara State and the Lady Mechanic Initiative and Market women in Lagos State. The benefit package provides coverage for the most common medical problems that are found among the target groups and consists of primary care, limited secondary care, medication and hospitalisation including HIV and AIDS treatment. The enrolled individuals have made thousands of visits to the hospitals. These visits have been for malaria, maternal care, hypertension, upper respiratory tract infections, musculoskeletal pains etc. – conditions which they would hitherto have had to pay for on an out-of-pocket basis or present to unorthodox healthcare providers. In many instances without appropriate healthcare interventions these conditions would have led to significant morbidity and mortality.
The scheme has also been involved in voluntary counselling and testing activities and identified HIV and AIDS positive enrolees who have been placed on ARVs when required. Community outreach activities focussed on topical public health conditions such as malaria, HIV and AIDS, hypertension and diabetes mellitus have also served to raise awareness about these conditions and preventive modalities.
Participating hospitals have also benefitted from the steady stream of income which the monthly capitation payments guarantee. They have also benefitted from an infrastructure and equipment upgrade grant which served to improve their quality of service delivery. Training and feed-back from regular monitoring and evaluation activities have also served to improve the quality of services at each of the participating hospitals.
The Hygeia Community Health Plan has revitalised the health system of benefitting communities. It also continues to serve as a catalyst towards the attainment of the millennium development goals.