Increasing access to child health services in resource-limited settings: experiences with the Obio Community Health Insurance Scheme

Abstract

Background: Nigeria’s 2010 Under-five mortality rate of 143/1000 live births and 64% of the population living below $1.25/day highlight the need for increased access to quality care for all, especially the U5s of whom only 23% received antibiotics for pneumonia and <50% appropriately treated for diarrhea and malaria. In 2010, Shell, as part of its social performance initiatives
in host communities, collaborated with Rivers State government, to upgrade the Obio health center to a Cottage hospital and initiated the Community Health Insurance Scheme(CHIS). Indigenes in the scheme’s target communities subscribe to it with the sum of N3,600 while others pay N7,200 per person annually and can access several services especially for Maternal, Neonatal and Child Health (MNCH).

Objectives: To share experiences from Obio CHIS and its impact on MNCH services.

Method: Data were retrieved from the records of Obio Cottage Hospital for the period 2009 to 2012 and analyzed.

Results: Facility utilization for MNCH and staff skills in record keeping, patient care, administration, laboratory and pharmaceutical services increased. The number of pregnant women screened for HIV increased from 141 in 2010 to 3,228 in 2012 while HIV seroprevalence reduced from 4.25% to 3.5% and all 57 HIV–exposed babies tested negative at 6 weeks. Similarly, the number
of children on GMP increased from 7,227 to 10,206 and percentage of underweight children reduced by over 150%.

Conclusion: The CHIS has thus contributed significantly not only to increased access to health services but also to improved child health indices in target communities.