Technical Support for the expansion of “ULERAWA
Technical Support for the expansion of “ULERAWA”- Ekiti’s State’s Health Insurance Scheme for the Vulnerable Population
DPD under its managed services workstream was engaged by the Ekiti State Health Insurance Agency to provide 1-year technical support to the scheme to expand its footprint and coverage from 5 LGAs to 171 PHCs across the 16 LGAs of the state. The platform’s consultants were engaged to evaluate the scheme’s activities, re-engineer its processes and re-position it on a path of performance.
Specific objectives of this support were as follows:
Technical support to the State Health Insurance scheme in institutionalizing a robust back-office system that will effectively support front-end activities in the health facilities. This included- business engineering and development of standard operating procedures (SOPs).
Deploy a capacity development mechanism that will transfer knowledge and skills from the pilot PHCs to the remaining PHCs within the Ulerawa program in a cost-effective manner.
Technical Approach
The project was divided into pre-implementation and implementation phases. The pre- implementation phase was designed to study and diagnose the system, design a strategy, and implement the strategy in the implementation phase. The baseline assessment used a conceptual and hypothesis driven approach in assessing the activities of EKHIS within domains of Community Mobilization, Service delivery, claims administration, Payment, Quality assurance, and Performance management between March – April 2023, and identified ten (10) key areas of improvement for the state especially capacity gaps and a lack of standard operating procedures. This conceptual framework provided a blueprint for achieving improved healthcare access, quality of care and effective functioning of the scheme and has been documented in an Ulerawa Manual/handbook.
In the implementation phase, the team led several trainings of OICs and Records Officers, provided technical & financial support for claims vetting using the Ulerawa e-platform, facilitated complaint management, supported supportive supervision activities of the State team, and implemented community mobilization activities across the 16 LGAs. Performance was tracked on a monthly and quarterly basis using an Excel based dashboard. Quarterly performance management entailed the assessment and ranking of LGAs based on several parameters and the pairing of 8 poorly performing LGAs with 8 high performing LGAs in an in-LGA mentorship (ILM) system that would last 3 months.
This ILM entailed the use of existing visible or latent structures in the state to drive and institutionalize the scheme. By design, ILM would drive training and peer-peer capacity development at the LGA and cascaded to the facility levels. This social linkage will serve as a platform for institutionalization and institutional memory, practical knowhow and bridge building between citizens and the scheme.
At the end of the project period, the DPD team was mandated to ensure capacities in the state team are built and processes institutionalized within the health insurance agency.