The Medicines Research and Access Platform (MedRAP) has advised NHIMA to seek the help of stakeholders in the medical circles in tackling its reported operational challenges.
Minister of Health Sylvia Masebo on Wednesday revealed that NHIMA had depleted its funds in the bank account owing to scheme abuse by the private sector which overcharges patients.
MedRAP Executive Director Liyoka Liyoka said MedRAP has observed that the depletion of NHIMA funds is a management and operational problem which started simmering some time back.
“This problem has slowly been creeping in, and hence foreseeable, such that proactive actions and strategic intervention could have been undertaken way back to avert the current financial status of the institution and getting where we are today.Hence, the alleged connivance with private sector providers to loot NHIMA funds in unscrupulous claims cannot be corrected by suspending or eliminating public benefit packages,” Mr Liyoka said.
“MedRAP has always advocated for NHIMA to be under the Ministry of Health (MoH) and we believe that it is now the appropriate time that MOH must provide proper policy oversight as regards the Authority’s benefit package and reimbursement system.We wish to strongly advise NHIMA to seek the help of stakeholders including professional associations in the medical circles to look at how this problem is affecting the provision of services under the scheme and how it can be resolved,” he said.
Mr Liyoka said NHIMA should also take stock of their revenue base with respect to how much they are collecting from individual members of the public, how many people are contributing to the scheme versus the amount they are reimbursing health providers based on those individual members’ accounts.
“There is also a need for strategic integrations of NHIMA into the MoH provision of services so that NHIMA can also come up with a situation where they are only able to reimburse for services that are provided in a manner that is transparent and affordable to the people of Zambia.We also urge NHIMA to include all SRH commodities to cater for Adolescent Friendly Health Services.MedRAP is hereby calling on the government through NHIMA not to resort to curtailing member benefit packages in future,” he said.
“The problem being faced by NHIMA is an operational and management issue. NHIMA should invest in risk management systems in their operational environment to help predict emerging management and operational challenges such as the alleged abuse of the scheme by the private sector. NHIMA should also speedily deal with loose-ends in its reimbursement system as well as member recruitment programme,” Mr Liyoka concluded.
