The Kwara State Health Insurance program wins the 2016 FT/IFC Transformational Business Award for Achievement in Sustainable Development: Maternal & Infant Health
This was presented during an FT/IFC award ceremony in London on Thursday, 9th June 2016.
The FT/IFC Transformational Business Awards are presented by the Financial Times (FT) and International Finance Corporation (IFC), a member of the World Bank Group and the largest global development institution focused exclusively on the private sector in developing countries. These awards recognize ground-breaking, long-term private sector solutions to key development issues. This year, the awards attracted 155 entries from 219 stakeholders, involving projects in 92 countries.
Kwara State Health Insurance program
The Kwara State Health Insurance program is built on a public-private partnership between the private insurer Hygeia Community Health Care, the Kwara State Government, the Health Insurance Fund and PharmAccess Foundation. The program, set up with the support of the Dutch Ministry of Foreign Affairs in 2007, has delivered substantial results in terms of improved maternal and child healthcare in Kwara State.
Since 2009, AIGHD and Amsterdam Institute for International Development (AIID) have carried out an extensive research program to study the impact of the Kwara State Health Insurance Program on socio-economic and health-related outcomes. The unique value of a program impact evaluation, initiated at the start of the program, is evident, now that the final data have become available.
Among other results, Kwara has shown an impressive rise in women giving birth in hospital, including women who aren’t in the health insurance program: hospital deliveries rose from 50% in 2009 to 70% in 2013, an increase which can be attributed to the program. World Bank data show that, since the start of the program, Kwara has become the second-best performing Nigerian state in maternal and child care.
Governor of Kwara State, His Excellency Abdulfatah Ahmed: ‘The Kwara State Health Insurance Program has indeed had a remarkable impact on the lives of low-income families in very remote areas of our state. The FT/IFC award to our program is a key international commendation of our ongoing efforts in steadily and surely improving access to affordable and qualitative healthcare in Kwara State. Such results are a great motivation for us to find a long-term, sustainable health financing solution so that this program can be expanded to benefit people across the state.’
In 2006, the Dutch Ministry of Foreign Affairs provided funding to pilot alternative mechanisms to the traditional development approach through the Health Insurance Fund. This flexible and long-term funding provided PharmAccess with essential legroom to test different innovative financing mechanisms (including health insurance and later mHealth) and build a strong network of partners such as and Kwara State Government and Hygeia in Nigeria. In a recent evaluation, the Boston Consulting Group concluded that the Ministry’s grant contributed to a significant change in the way the role of private sector development in healthcare is perceived today.
Dutch Minister for Foreign Trade and Development Cooperation, Lilianne Ploumen: “This award is a great recognition. First of all, because improving the vulnerable situation of young mothers and their newborns is high on my agenda. And secondly, this program shows that progress can be made through the public-private model. Our public funding has enabled the private sector to play a crucial role in making healthcare available to people who until recently couldn’t afford an insurance. We hope this success will trigger others to support programs like this as well.”
Chairman of Health Insurance Fund, Kees Storm: “When we started with this initiative back in 2006, we asked ourselves: how can we make sure we use all available resources to protect low-income families in Kwara from the risks to both their health and their wealth? The long-term support of the Dutch Ministry of Foreign Affairs gave us the chance to answer this question. Now, this unique public-private partnership has proven that it can be done: affordable, state-supported quality healthcare, bringing supply and demand together with the help of insurance mechanisms.”
Managing Director of PharmAccess Group Onno Schellekens: “As this program was treading new ground, we made scientific impact research an integral part of our approach from the very beginning. Not knowing where to start is no excuse not to. Advocating for policy change starts with proof of principle.” The creativity and perseverance involved in building this transformational program from scratch was one of the features that impressed the FT/IFC jury.
Improving maternal and child care
Director of Hygeia, Fola Laoye: “While Nigeria constitutes 2% of the world’s population it accounts for up to 14% of global maternal deaths. More than 12% of children born in Nigeria will not reach their fifth birthday. Health insurance still has very low penetration, leading to catastrophic health expenditure and overall poor quality of services. In Kwara, we proved that we do not have to accept this situation. In this unique public private partnership Hygeia as a private insurer could develop affordable health insurance and therefore access to quality services, improving the health outcomes in some of the poorest communities of Nigeria.”
The program aims to improve access to affordable healthcare for low-income households through complementary initiatives on both the demand and the supply side, including subsidized health insurance and stimulating investments in quality of care, such as upgrading healthcare facilities and implementing quality standards and improvement plans. Rigorous scientific and operational research has led to improvements to the program as well as insights into the impact of the program, such as a significant reduction in out-of-pocket spending on healthcare and an improvement in health outcomes.
CEO of Achmea and Health Insurance Fund board member Willem van Duin: “This insurance program shows that it’s possible to organize solidarity towards access to better healthcare, even among the lowest income groups in Africa – like farming families in Kwara. The great challenge ahead is now to start the Kwara State Health Insurance Fund, in which all citizens contribute according to their financial strength and assure access to care for the poor as well as the rich, the sick and the healthy, the young and the old. The Kwara program demonstrates how public funding can reduce risks and costs for all stakeholders. This has spurred private investments and allows even the lowest income earners to insure against health expenditures. With this kind of solidarity, families in Kwara can invest in their future.”