Nigeria’s Health Insurance Authority Takes a Big Step Forward on the Quality Improvement Journey
Nigeria’s largest purchaser of healthcare and regulator of all health insurance schemes has entered the next phase of its journey to better measure and improve the quality of care in its network by working with PharmAccess.
By Dr Ibironke Dada (SafeCare) and Dr Yakubu Agada-Amade (NHIA)
Deploying digital technology in healthcare can improve quality, support safety measures, improve data management, simplify processes, and promote the delivery of better outcomes.
Nigeria’s health leadership recognized that these benefits could strengthen its health system at the National Council on Health meeting in November 2023. The theme gained further traction in the government’s reform agenda, as articulated in the Health Sector Renewal Initiative. The initiative’s key pillars include improving the quality of care across health facilities, strengthening regulatory capacity, and better data management by digitalizing the operations of the National Health Insurance Authority (NHIA) – Nigeria’s largest strategic purchaser of healthcare with over 7,000 accredited health facilities. The NHIA is charged with driving universal health coverage (UHC) in Nigeria through regulation, promotion and integration of all health insurance schemes
While digital technology holds many advantages for healthcare providers, regulators such as the NHIA especially stand to benefit as it can support quality assurance systems. Key tasks includer egulating health insurance schemes, managing the accreditation of healthcare facilities, and integrating all health data that relates to health schemes – functions that can be most effectively implemented using digital technology. Indeed, the NHIA’s Strategic Plan for 2020-2030 promotes the use of digital technology to systematically track insurance-related programs, activities, and performance across the country.
The partnership commenced in 2021
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To help implementits strategic plan, the NHIA partnered with PharmAccess in July 2021. First up was developing and digitalizing the NHIA’s accreditation processes. Then its Standards and Quality Assurance Unit received training on SafeCare standards and methodologydeveloped by PharmAccess.
In March 2024, the NHIA and PharmAccess held a two-day strategy workshop develop its scoring algorithm and ranking methodology using key learnings from SafeCare’s quality rating system. NHIA will rank healthcare facilities within her network based on their quality scores and compliance with critical criteria which will support performance-based contracting and payments.
At the workshop, key personnel from the NHIA, Ministry of Health, and PharmAccessreviewed the nationwide pilot of the newly digitalized NHIA quality accreditation tools and extensively discussed the scoring algorithm. Health facilities that do not meet the NHIA’s staffing, equipment, and infrastructure requirements will not be accredited or re-accredited to provide services to health insurers.
Now: Access to key SafeCare components
In the latest step forward on its journey to improve the quality of care in Nigeria, the NHIA signed an agreement with PharmAccess at the end of July 2024. This allows the Authority access to key components of the SafeCare toolbox, including the Quality Evaluation System (QES) and Quality Platform. The ultimate aimof this collaboration is the co-creation of an NHIA-owned accreditation and quality assurance toolbox that is benchmarked against the industry best and optimized to compete with any of its type in the world.
Using the QES, the NHIA can conduct thorough quality assessments, generate detailed reports, and develop targeted quality improvement plans for facilities. Once assessed, all the facilities in the NHIA network will be onboarded on the Quality Platform where they can access resources to further improve quality.The Quality Platform will facilitate extensive data analytics, provide optimal visibility to quality improvement activities, and connect the entire ecosystem of stakeholders in the NHIA’s network.
PharmAccess will continue to offer technical support services and conduct periodic trainingto enhance the NHIA’s capacity to manage accreditation and quality assurance activities effectively.
“We are dedicated to supporting the NHIA with the resources and expertise necessary to enhance healthcare quality within its network,”said the country director of PharmAccess, Njide Ndili. “Our partnership will facilitate data-driven decision-making and foster a culture of continuous improvement in healthcare delivery.
With input from Health Ethics and Law Consulting‘s Prof Cheluchi Onyemelukwe and Olawale Bhadmus.
