NHIMA gets international recognition for Good Practices in Social Security Administration

Abidjan, Cote’ D’Ivoire

The National Health Insurance Management Authority (NHIMA) has been awarded three (3) Certificates of Merit at the ongoing International Social Security Association (ISSA) Regional Social Security Forum in Abidjan, Cote’ D’Ivoire. The Certificates of Merit under the ISSA Good Practice Awards are a strong recognition of NHIMA’s innovation and good practice in the administration of the National Health Insurance Scheme for the achievement of Universal Health Coverage.

The three ISSA Good Practice Awards received are:

Certificate of Mention with Special Mention – For NHIMA’s innovation in the implementation of the Biometric Claims Management System called APACE. The APACE system is a biometric reader system that captures biometrics of all NHIS members and their beneficiaries, replacing the paper-based claim forms. All Health Care Providers are equipped with an APACE biometric reader system for the identification of members. To access services, members log in using the biometric reader, and once services are offered, they log-out. Immediately after the log-out, the services accessed, and their costs are immediately transmitted to the NHIMA Claims Processing centre and queued for adjudication and payments. This system has reduced the claims processing time, reduced fraud associated with paper claims and enhanced data capture and analytics for decision making.

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Certificate of Merit – For NHIMA’s implementation of the Actuarial Valuation Capacity Building Programme for the estimation of estimation of prospective liabilities for the extension of NHIS coverage to the poor and vulnerable under the Social Cash Transfer Programme. NHIMA, in collaboration with ILO and the European Union has initiated an Actuarial Modelling Capacity Building Project using the ILO HEALTH Actuarial Modelling Tool managed by the Public Finance, Actuarial and Statistics Unit of the ILO’s Social Protection Department in Geneva. This project helped build NHIMA’s actuarial modelling capacity and developed real-time estimation of the NHIS’ Solvency Position while providing data and evidence on the required financing for Universal Health Coverage. This innovation and practice will guide NHIMA and the government on the development of strategic financing policies for extension of NHIS while maintaining Scheme solvency.

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Certificate of Merit - For NHIMA’s implementation of the Claims Advance Payment System (CAPS) to enhance the preparedness of Public HealthCare Providers (HCPs) under the NHIS. The Claims Advance Payment (CAP) was introduced to capacitate the HCPs and supplementing HCPs financing to activities that will promote the provision of quality health care services in government hospitals. The CAPs are then repaid through the claims that the HCPs make to the NHIS, after which an enhanced replenishment is made. The CAP strategy has augmented government financing and enhanced the quality of services in public HCPs while enhancing financial accountability in the use of public funds. Since inception, NHIMA has paid over K60 million in CAPs to government health facilities. Through the CAPs, government health facilities have been able to:

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·?????Renovate their health facilities.

·?????Procure drugs and medical, reagents and medical in times of shortage.

·?????Hire additional staff to meet client demand.

·?????Enhance the quality of service for NHIS members.

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The awards were handed to the NHIMA Director General, Mr. Michael Njapau by ISSA President, Dr. Mohammed Azman at the Sofitel Abidjan Ivoire H?tel in Abidjan, Ivory Coast. In receiving the Awards, Mr. Michael Njapau expressed gratitude to ISSA for the recognition, and thanks all NHIMA Staff for their diligence and hard work. He committed to furthering excellence in service delivery in the execution of NHIMA’s mandate for the achievement of operational excellence and Universal Health Coverage. The Director General was accompanied by Dr. Evans Chungu - Board Director, Mr. Herryman Moono – Director Research & Planning, and Mr. Jacob Chirwa, Project Lead – NHIMA ZSIC Life Project.