Kiri Victor Alangibi, Ojule Aaron C
Department of Mathematics, Physics and Electrical Engineering, Faculty of Engineering and Environment, Northumbria University, Newcastle Upon Tyne, United Kingdom; Department of Pharmacy, Faculty of Pharmaceutical Sciences; Department of Chemical Pathology, College of Health Sciences, University of Port Harcourt, Choba, Rivers State, Nigeria.
Department of Chemical Pathology, College of Health Sciences, University of Port Harcourt, Choba, Rivers State, Nigeria.
Niger Postgrad Med J. 2020 Jan-Mar;27(1):1-7. doi: 10.4103/npmj.npmj_141_19.
Pubic health insurance schemes are usually set up by governments to provide cover for their insured populations against healthcare costs. These schemes are usually administered by a government agency and vary both in how they are funded and provide their services. A number of developing countries have introduced such schemes to minimise the impact of financial barriers to healthcare access by their populations. These schemes are expected to bridge the inequality in healthcare. A National Health Insurance Scheme has been in operation in Nigeria since 2005 to provide health cover for government employees and those in private institutions with no less than ten workers. There are similar schemes in a number of countries in sub-Saharan Africa. We conducted a literature review of publications on public health insurance schemes in sub-Saharan Africa to identify the challenges they encounter. We found 76 relevant publications. Although much have been published on these schemes, few have addressed the critical obstacles to effective implementation, management and sustenance in the unique environments we find in sub-Saharan Africa - where poor technological infrastructures, acts of forgery, counterfeiting and other forms of fraud are common. We highlight these challenges, using the scheme in Nigeria for reference. We discuss the potential role of robust electronic medical record (EMR) systems for sustainable schemes in such environments and describe some of the ways robust EMR systems could be used to mitigate the challenges posed by most of the peculiar problems associated with poor infrastructures.
公共医疗保险计划通常由政府设立，为参保人群支付医疗费用提供保障。这些计划通常由政府机构管理，在资金筹集方式和服务提供方式上各不相同。一些发展中国家推出了此类计划，以尽量减少民众在获取医疗服务时面临的经济障碍的影响。这些计划有望消除医疗保健方面的不平等现象。自2005年以来，尼日利亚一直在实施一项国家医疗保险计划，为政府雇员以及拥有不少于十名员工的私立机构人员提供医疗保险。撒哈拉以南非洲的一些国家也有类似的计划。我们对撒哈拉以南非洲关于公共医疗保险计划的出版物进行了文献综述，以确定它们所面临的挑战。我们找到了76篇相关出版物。尽管已经有很多关于这些计划的文章发表，但很少有文章探讨在撒哈拉以南非洲独特环境中有效实施、管理和维持这些计划所面临的关键障碍，在这种环境中，技术基础设施薄弱、伪造、假冒和其他形式的欺诈行为很常见。我们以尼日利亚的计划为例，突出这些挑战。我们讨论了强大的电子病历（EMR）系统在这种环境下对可持续计划的潜在作用，并描述了一些利用强大的电子病历系统来缓解与基础设施薄弱相关的大多数特殊问题所带来挑战的方法。
