1. Submission Of 2018 Nationwide Monitoring & Evaluation/Providers Enrollees Sensitization Enlightenment Report To NHIS & Defence Health Maintenance Limited (DHML) Stakeholders
One of the essential roles of DHML as a Health Maintenance Organization is the Monitoring and Evaluation (Medical and Financial) of DHML contracted health care facilities as well as enrollee enlightenment programs. DHML 2018 Nationwide Monitoring and Evaluation (quality assurance) of all Armed forces and contracted civil health care facilities was carried out in all the 36 states of the country in line with NHIS guidelines on the 29th of October-9th of November 2018.A total number of 419 facilities were visited and inspected out of which 159 were Military facilities while the civilian facilities were 260 in number. The report of the exercise revealed that DHML enrollees are very satisfied with DHML as their HMO. Some of the constraints highlighted by the enrollees include huge cost of payment for services which were not covered by the scheme. The healthcare providers complained that the current tariffs of NHIS for healthcare services are no more realistic.
Major complaints of enrollees and the healthcare providers as well as DHML recommendations were well outlined in the 2018 Nationwide M&E report and it has been submitted to NHIS and DHML stakeholders for necessary actions.
2. Stakeholders/Quality Assurance Meeting
As part of our duty as an HMO to deliver quality assurance, the department attended a stakeholders meeting with the Chief Medical Director (CMD) of St Mary’s Catholic Hospital Gwagwalada, Dr J.O Ogie. The CMD of the hospital commended DHML for its regular and prompt payment of bills. DHML Monitoring and evaluation Officers used the medium to address the complaints made by our enrollees in the hospital, such as out of pocket payments for some drugs and services in the hospital .The CMD promised to put an end to such act.
3. In House Training
The department also had an in house training with focus on job dedication, enrollee registration, enrollee identification and skills of customer care in the Health maintenance organization (HMO) business
4. 2019 First Quarter Monitoring And Evaluation
NHIS guidelines mandate all HMOs in Nigeria to ensure high level of quality healthcare services at all level of care. It is mandatory for HMOs to periodically access and evaluates healthcare providers under their network. DHML state managers in all the 36 states across the federation carried out 2019 first quarter monitoring and evaluation exercise as part of DHML continuous quality measures. The reports of the exercise from all states of the country have been put together by DHML M&E department at the head office. Several follow up actions were taken in response to some of the observations of DHML state managers during the exercise. The report revealed several remarkable improvements of healthcare providers in terms of infrastructures and quality of service delivery to enrollees. One of such remarkable improvements is that many military health care providers have procured mobile intensive care unit ambulances for effective management of emergencies cases in transit. Also worthy of note is the exceptional patient centeredness relationship established by Mulib Hospital Sango Otta Ogun state.The hospital renders good healthcare services to DHML enrollees and does not collect 10% co-payment on drugs. DHML MD/CEO has written a letter of commendation to the Medical Director of Mulib Hospital Sango Ota Dr Ibrahim Adeleke, for promoting the objectives of NHIS.
5. Enrollee Assessment Feedback Session Via Phone Call
The monitoring and evaluation department carried out a feedback session with DHML enrollees in Nigeria via phone calls to assess their satisfaction levels. Enrollees were randomly selected from all states of the country via DHML Database. The exercise was largely successful. Most of our enrollees were very satisfied with the level of care being received. Some enrollees however lamented the huge cost of payments for drugs and investigations not covered under NHIS and unprofessional attitudes of some health workers. Some enrollees complained of compulsory feeding policy of some Teaching Hospitals in South Eastern part of the country, which put additional financial burden on them. The management of DHML has written the affected Hospitals to set aside such policies for DHML enrollees and a formal response stating that such policies will not be imposed on our enrollees has been received from some of the hospitals.
Dr Oladipo Oladeji
Head, Monitoring& Evaluation Department
DHML Head Office