Health plan refers to a bundle of medical services a client is entitled to once they have been enrolled under the Commission. The Health plans offered by Edo State Health Insurance Commission include;
The Equity Health Plan provides Basic Minimum Packages for Health Services (BMPHS). It is for residents the Scheme classified as vulnerable in the Society. It is funded through the allocated State and Federal Government consolidated revenue. The Edo State Equity Health Plan is designed to provide Health Services to Persons who, due to their physical status (including age) cannot engage in any meaningful economic activity.
Membership
Membership will be based on selection and verification by the National Social Safety-Net Coordinating Office (NASSCO). Membership shall be open to persons in the Vulnerable category. Residents eligible to benefit from this health plan include;
1.Physically and mentally challenged persons.
2.Poor pregnant women.
3.Orphans with no support system.
4. Children under five (5) years living below poverty line.
5.Poor elderly residents (60 years and above)
6.The less privileged
7.Such other categories of persons as may be prescribed by the Commission from time to time.
Contributions
Contribution under the equity health plan shall be made by the federal and state government on behalf of residents enrolled on the scheme. This shall include;
- Equity Fund (by law requires a provisioning of not less than 1% of the State’s consolidated revenue to be set aside to pay for the delivery of healthcare services to residents termed “vulnerable”.
- Basic Healthcare Provision Fund (BHCPF) from the Federal Government.
- 2% of all gross premiums paid on the other health plans of the Scheme.
- Fees and commissions charged by the Commission.
- Dividends and interest on investment and stocks.
- Donations or Grants in Aid from well-meaning individuals, corporate bodies, private organizations, International donor organizations, nongovernmental organizations etc.
- All other monies as may accrue to the Commission
Waiting Period
There shall be no waiting period before accessing care for residents registered under the Equity Health plan.
Registration Procedure
The Formal Health Plan is for employees in the Public sector and the Private Organized sector. It covers Father, Mother and 4 Children under 18years of age, irrespective of whether either or both parent work in the public or private sector. It is a social health insurance plan in which the healthcare of employees in the Formal Sector is paid for from funds pooled through contributions of employees and employers.
Membership
The Formal Sector consists of the following:
1. The Public Sector which covers all employees of the state, and
2. The Organized Private Sector which covers all employees of organizations with a staff strength of five personnel or more.
Note: The contributing resident under this health plan shall be enrolled as a principal and his/her membership shall cover the principal, his/her spouse and four children under eighteen years of age who shall be registered as dependents under the principal. More dependents or a child above the age of eighteen (18) may be covered on the payment of additional contributions by the principal beneficiary as determined by the Commission.
Contributions
Contributions are earnings-related. For Public sector workers, the employer (State Government) shall pay 1.75% of the gross monthly salary of employee while the employee shall make a contribution of 1.75% of his/her gross monthly salary, representing 3.5% of the employee’s consolidated monthly salary.
Political appointees and pensioners shall make a contribution of 5% of their gross salaries, channeled towards their health insurance plan under the Formal Sector Health plan.
For organized private sector, deductions and co-contribution from employer shall be determined by the administrative framework of such organization. An employer may however, decide to pay the entire contribution. The employer may also undertake extra contributions for additional services to those specified under the formal sector health plan, such as the Enhanced Health Insurance Plan.
Waiting Period
There shall be an administrative waiting period of sixty (60) days before beneficiaries can access healthcare services in the health facilities assigned to them.
Registration Procedure
1. Every formal sector employer in Edo state shall register with the Commission.
2. Every employer shall affiliate itself with the Commission.
3. The registration of prospective enrollees shall be the responsibility of the Commission.
4. Every registered employer shall supply the following information to the Commission;
a. Name of employer.
b. Category of employer (public or private).
c. Nominal rolls containing staff details and gross salaries.
5. The employee shall register self, a spouse and four (4) children below the age of eighteen (18) years.
6. The employer shall bear the cost of production of initial insurance identity card(s) of his/her employees.
7. The employee shall bear the cost of production of the following:
a. Additional dependents’ insurance identity card(s).
b. Replacement of insurance identity card(s) in case of theft, damage or loss.
Benefit package
The Health Benefits applicable under the Formal Sector Health Plan shall include:
1. Health Promotion
▪ Health promotion: communicable & non-communicable diseases
▪ Hygiene, sanitation and environmental health
▪ Fight against stigma of patients with chronic diseases, e.g. chronic diseases, mental health, HIV, epilepsy
▪ Education on non-communicable diseases
▪ Dental health promotion
2. Preventive Health Services
▪ Health check-up
▪ Routine child health Examination-Routine health check for child over 28 days of age through 19 years of age.
▪ Routine newborn health Examination-Health examination for infant under 29 days of age
▪ General counselling and advice on Contraception-Family planning advice NOS/ Initial prescription of contraceptives
▪ Insertion of (intrauterine) contraceptive device
▪ HIV voluntary counselling & testing (VCT) and prevention of mother-to child transmission (PMTCT)
▪ Contact with and (suspected) exposure to HIV/Post Exposure Prophylaxis (PEP)
▪ Precautionary measures against COVID 19.
3. Outpatient Services
▪ General Medical Consultation
– General Practice
– Dental
▪ Specialist
– Ophthalmology
– Obstetrics & Gynecology
– Ear, Nose, and Throat (ENT)
4. Internal Medicine
– Treatment of Plasmodium falciparum malaria
– Other severe and complicated malaria
– Uncomplicated febrile illness
5. Respiratory diseases
– Nasopharyngitis – Treatment of Acute nasopharyngitis [common cold]
– Respiratory distress – Airway management for respiratory distress
– Pneumonia – Antibiotic treatment of Pneumonia
– Asthma
– Prophylaxis (avoidance of allergens)
– Pharmacological management: bronchodilators & corticosteroids
– Nebulizer Therapy
– IV pharmacological therapy (Salbutamol & MgSO4)
– ENT Conditions
– Pharmaceutical Management
– Acute bronchitis
– Tuberculosis
– TB screening
– Preventive treatment using Anti-tuberculosis drugs
– Tuberculosis treatment
– Influenza – Treatment of influenza due to identified seasonal influenza virus
6. Gastrointestinal Diseases
▪ Acute gastroenteritis – Oral and IV fluids
▪ Persistent diarrhea – Oral and IV fluids
▪ Bleeding esophageal varices
– pharmaceutical treatment
– Resuscitation with IV replacement
▪ Typhoid and paratyphoid fevers – Drug treatment of typhoid and Paratyphoid fevers
▪ Cholera – Treatment of Cholera including Antibiotic therapy
▪ Other bacterial, Viral and other specified intestinal infections
– Patient assessment
– Basic investigation (haematology, Medical microbiology, biochemistry, echography)
– Advanced investigation (pathology, endoscopy)
– Basic management (symptomatic management using drugs)
▪ Diabetes Mellitus
– Lifestyle modification (nutrition & physical activity)
– Insulin therapy
▪ Infectious and parasitic diseases
– Treatment of Helminthiasis – schistosomiasis
– Treatment of Helminthiasis-Other fluke infections
– Treatment of Helminthiasis-Taeniasis
– Treatment of Other cestodes infections
– Treatment of Dracunculiasis-Guinea worm infection
– Treatment of Onchocerciasis
– Treatment of Hookworm diseases
– Treatment of Ascariasis roundworm infection
– Treatment of Enterobiasis
– Treatment of Strongyloidiasis
– Treatment of Herpes viral [herpes simplex] infections
– Treatment of Varicella [chickenpox]
▪ Anaemia – Simple anaemia (not requiring blood transfusion)
▪ Snake Bites, Dog bites and other venomous bites Treatment for Toxic effect of contact with venomous animals
▪ Arthritis – Basic Treatment of arthritis
▪ Hypertension – Treatment and management of hypertensive disorders
7. Paediatrics
▪ Normal Newborn Care
– hypothermia of newborn
– Umbilical cord care
– Breastfeeding
– Eye prophylaxis
– Vitamins
– Anemia prevention
– Infection prevention
– immunization against poliomyelitis
– immunization against yellow fever
– immunization against measles alone
– immunization against viral hepatitis
– immunization against tuberculosis [BCG]
▪ Prematurity Management of prematurity
– Incubator
– Warming/ Kangaroo Mother Care (KMC)
– Follow up with Supplementation of Multi Vitamins; Vit D, Calcuim and Fe.
▪ Low birth weight (<2500g)
– Nutrition Breastfeeding
– Intravenous 10% dextrose (IV D10%)
▪ Neonatal Infections:
– mild Intravenous antibiotics
– Antifungal and Antiviral
▪ Severe infection(Sepsis)
– Intravenous IV fluids
▪ Neonatal jaundice
– Intravenous IV fluids
▪ Birth Asphyxia
– hypothermia treatment
8. Maternal and Neonatal Services
▪ Screening for maternal illnesses
▪ Antenatal Care +Normal Delivery +Postnatal Care Six weeks after delivery Antenatal Care
▪ Postnatal Care (6 weeks’ delivery)
▪ Operative management of Ectopic pregnancy
▪ Single spontaneous delivery
▪ Multiple delivery
▪ Hemorrhage in early pregnancy
▪ Treatment of Excessive vomiting in pregnancy
▪ Treatment for Infections of genitourinary tract in pregnancy
▪ Diabetes in pregnancy, childbirth, and the puerperium
▪ Treatment of Malnutrition in pregnancy, childbirth and the puerperium
▪ Treatment for hypertensive disorders of pregnancy
▪ Treatment for anaemia
▪ Iron & folic acid supplementation
▪ Tetanus and hepatitis vaccinations at the Dispensary Tetanus vaccination
▪ Counseling on family planning, birth and emergency preparedness
▪ Prevention & management of malaria
▪ Smoking cessation
▪ Screening & treatment of syphilis
▪ De-worming
▪ Treatment of urinary tract infections (UTI)
▪ Prevention of pre-eclampsia: • Calcium • Low dose
▪ Treatment of eclampsia: magnesium sulfate
▪ Induction of labor to manage pre-labor rupture of membranes at term
▪ Prevention of respiratory distress syndrome (RDS) in preterm babies
▪ Monitoring labour
▪ Induction of labour for prolonged pregnancy
▪ Episiotomy
9. Basic Emergency Obstetric Care
▪ Manual removal of placenta
▪ Assisted vaginal delivery
10. Comprehensive Emergency Obstetric Care
▪ Caesarian-section including prophylatic antibiotics
11. HIV /AIDS
▪ Human immunodeficiency virus [HIV] disease management with (First Line ART)
▪ Human immunodeficiency virus [HIV] disease management with (Second Line ART)
▪ Treatment of complications requiring admission
12. Sexually Transmitted Infections STI
▪ Treatment of bacterial vaginosis
▪ Chlamydial infection
▪ Treatment of Gonorrhea
▪ Treatment of syphilis
▪ Treatment of Vulvo-Vagina Candidiasis
13. Eye Care
▪ Full refraction and prescription of glasses
▪ Dispensing glasses < 5000 Naira once every two years
14. Glaucoma Services
▪ Glaucoma screening (IOP)
▪ Glaucoma Confirmation tests
▪ Prescription for Glaucoma
▪ Glaucoma Surgery
15. Conjunctivitis
▪ Diagnosing Conjunctivitis
▪ Treatment of Conjunctivitis (all)
16. Dental Care
▪ Extraction (excluding third molar)
▪ Dental care limit Incision and Drainage
▪ Excisional Biopsy
▪ Incisional Biopsy
▪ Suturing
▪ Almalgam Filling
17. Laboratory investigations
▪ Haematocrit PCV
▪ Haemoglobin Hb
▪ Complete blood count
▪ Blood typing
▪ Bleeding and clotting times
▪ Erythrocyte Sedimentation Rate (ESR)
▪ Biochemistry Proteinuria and Glucosuria
▪ Rapid Diagnostic Test (RDT) for malaria
▪ Drug monitoring assays
▪ Rapid pregnancy test
▪ Serum bilirubin
▪ Blood glucose
▪ Rapid plasma reagin (RPR) for test for syphilis
▪ Rapid HIV test
▪ Rapid hepatitis B & C tests
▪ Liver function tests
▪ Renal function test
▪ Urine M/C/S
▪ Swabs (Ear, Eye, Nose,Wound, High Vaginal Swab HVS, Urethra, Pus)
▪ Aspirates M/C/S
▪ Cerebrospinal Fluid M/C/S
▪ Sputum M/C/S
▪ Acid-Fast bacillus AFBX3
▪ Seminal Fluid Analysis (SFA)
▪ VDRL
▪ Widal test
▪ Malaria Parasite
▪ Mantoux test
▪ Blood Culture
▪ Urine Microscopy
▪ Stool Microscopy
▪ Cerebrospinal Fluid (CSF) microscopy
▪ Semen M/C/S
▪ Urinalysis
▪ Skin snip
▪ Skin scrapping
▪ Fecal occult blood
▪ High Vaginal Swab (HVS) M/C/S
18. Diagnostic Radiology
▪ Chest X Ray (PA, Lateral)
▪ Chest X Ray (PA)
▪ X-ray Abdomen (Erect/supine)
▪ X-ray Abdomen (KUB)
▪ X-ray Ankle joint (AP,Lateral)
▪ X ray Arm (AP, Lateral)
▪ X-ray Cervical Spine (AP, Lateral)
▪ X-ray Elbow (AP, Lateral)
▪ X-ray Foot (AP, Lateral)
▪ X-ray Fore arm (AP, Lateral
▪ X-ray Hand (AP, Lateral)
▪ X-ray Hip Joint
▪ X-ray Knee Joint (AP, Lateral)
▪ X-ray leg (AP, Lateral)
▪ X-ray Neck (soft tissue/ AP Lateral)
▪ X-ray of the paranasal sinues
▪ X ray Pelvis
▪ X-ray Post nasal space
▪ X-ray Shoulder AP
▪ X-ray Shoulder AP, Lateral
▪ X-Ray Skull AP, Lateral
▪ X-ray Wrist (AP, Lateral)
▪ X-ray Lumbosacral spine
▪ Mammography
▪ Transvaginal USS
▪ Abdomino Pelvic
▪ Abdominal
▪ Pelvic USS
▪ Prostate USS
▪ Renal USS
▪ Breast USS
▪ Obstetric USS
▪ Xray Femur
▪ Xray Humerus
19. General Surgical Procedure
▪ Minor Surgical Procedures
▪ Surgical Care Limit Minor wound debridement
▪ Evacuation of impacted faeces
▪ Drainage of paronychia
▪ Circumcision of male infants
▪ Relief of urinary retention
▪ Corrections of cases of simple polydactyly
▪ Appendectomy
▪ Hernia repair
▪ Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
▪ Oxygen Therapy (up to 3 sessions)
▪ Urinary Catherization
▪ Venous Cutdown
20. Emergency Care
▪ Establishing an intravenous line
▪ Simple tracheostomy
▪ Management of convulsion, coma, etc.
▪ Control of bleeding using pressure and simple suturing
▪ Assisted respiration (e.g. Ambu bag, etc.)
▪ Immobilization of fractures (using splints, neck collars, etc.)
▪ Aspiration of mucus plug to clear airways
▪ High risk deliveries
▪ Hysterectomy
▪ Myomectomies
▪ Ovarian cystectomy
21. Ambulatory Services (Ambulance)
The Edo State Informal Sector Health Plan is a Social Health Plan for residents in the Informal Sector. It is designed to cater for the health needs of residents who are self-employed, employed by private organizations with a staff strength of between 1 to 5 personnel. This Health plan has been categorized into A, B and C according to the income level of residents in the sector.
Members
Residents covered under this health plan shall include Self-employed residents, employers and employees of organizations with a staff strength of less than five personnel, Artisans and other residents not covered under the other four health plans of the scheme.
Contributions
The Informal Sector Health Plan shall be funded through contributions (Premiums) paid by residents enrolled into the health plan. There shall be a co-contribution between employers and their employees under this Health Plan. Contributions to be made shall be actuarially determined by the Edo State Health Insurance Commission.
Waiting Period
There shall be an administrative waiting period of sixty (60) days before Beneficiaries under this health plan can access care in the health facilities assigned to them.
Registration Procedure
Registration will be carried out at EDHIC office, Health Facilities accredited by the Commission or any other point of Registration as may be provided by the Commission from time to time.
Benefit Package
Informal Health PLAN A
PRIMARY CARE
1. General consultation with prescribed drugs from accredited PHC facilities.
2. Health education for prevention of diseases
▪ Family planning excluding provision of commodities (Safe period, pills, condoms, etc.)
▪ Dental health
▪ HIV/AIDS/Tuberculosis/Malaria
▪ Immunization
▪ Vitamin A supplementation
▪ Promotion of essential nutrients for children and pregnant women
▪ Promotion of personal, domestic and environmental hygiene, etc.
▪ Precautionary measures against COVID 19.
3. Primary Care Surgery
▪ Minor Surgical Procedures: incision & drainage, suturing of lacerations, minor burns, simple abrasions.
▪ Minor wound debridement
▪ Circumcision of male infants
▪ Evacuation of impacted faeces
▪ Relief of urinary retention
▪ Primary eye care including treatment of:
–Conjunctivitis
–Parasitic and allergic ailments
–Simple contusion, abrasions etc.
4. Primary Care Pediatrics
▪ Child Welfare Services-Growth monitoring, Routine immunization as defined by the NPHCDA, Vitamin A supplementation, Nutritional advice and health education, etc.
▪ Management of uncomplicated malnutrition
▪ Treatment for Helminthiasis
▪ Treatment of common childhood illnesses such as malaria, diarrheal disease, schistosomiasis, upper respiratory tract infections and uncomplicated pneumonia,
▪ Urinary Tract Infections (uncomplicated),
▪ Simple otitis media, pharyngitis,
▪ Childhood exanthemas, simple skin diseases/infestations and other viral illnesses such as mumps
▪ Other febrile illnesses as may be listed from time to time.
▪ Treatment of anemia not requiring blood transfusion.
5. Primary Care Internal Medicine (Adult)
▪ Management of simple infections/infestations
–Malaria
–Respiratory tract infections
–Urinary tract infections
–Gastroenteritis
–Primary ear, nose and throat infections
–Diarrheal diseases
–Enteritis/ typhoid fever
–Schistosomiasis
–Helminthiasis
–Skin infections/infestations such as chicken pox and fungal diseases e.g. Tinea versicolor,
Malassezia furfur, Tinea capitis etc.
–Emergency management of bites and stings e.g. snakes, scorpions, bees, spiders etc. (Minus serum)
–Other uncomplicated bacteria, fungal, parasitic and viral infections and illnesses
▪ Management of simple anemia (not requiring blood transfusion)
▪ Screening & referral for diabetes mellitus, hypertension and other chronic diseases
▪ Treatment of simple arthritis and other minor musculoskeletal diseases
▪ Routine management of sickle cell disease
▪ Allergies
6. HIV/AIDS/Sexual Transmitted Diseases
▪ Voluntary Counseling and Testing (VCT)
1. Primary Care Mental Health Management
▪ Anxiety neurosis
▪ Psychosomatic illnesses
▪ Insomnia
▪ Identification of drug abuse
▪ Other illnesses as may be listed from time to time by NPHCDA
2. Primary Care Maternal, Neonatal and Child Health (MNCH) Services
▪ Antenatal care
–Routine antenatal clinic
–Routine drugs to cover duration of pregnancy
–Routine urine and blood tests
–Referral services for complicated cases
▪ Postnatal services –All eligible livebirths up to 6 weeks from date of birth. (Cord care, Eye care, Management of simple neonatal infections)
▪ Delivery services
–Spontaneous Vaginal Delivery by skilled attendant including repair of birth injuries and episiotomy
–Essential drugs for Emergency Obstetric care (EmOC)
3. Primary Care Emergency Services
▪ Understand the use of simple ABCD protocols and prioritize lifesaving over cause finding
▪ Airway assessment and use of airway adjuncts
▪ Use of basic means of airway aspiration and clearance
▪ Breathing assessment and use of simple equipment to aid and monitor breathing like ambu bags
▪ Pulse oximetry
▪ Control of bleeding using compression dressing
▪ Assessment of hemodynamic stability
▪ Establishment of intravenous line and venous cut down
▪ Fluid resuscitation
▪ Basic cardiopulmonary resuscitation
▪ Use of early warning signs
▪ Recognition of signs requiring prompt referral particularly in children, pregnant women and the elderly.
▪ Assessment and basic management of the unconscious patient
▪ Suturing of small lacerations where no resuscitation is required.
▪ Immobilization of fractures and cervical spine using pre-provided splints
4. Basic laboratory investigations
▪ Urinalysis
▪ Haemoglobin Hb/ Packed Cell Volume PCV
▪ Stool microscopy
▪ Urine microscopy
▪ Pregnancy Test
▪ Blood Glucose Test
Note: the primary healthcare facility of the enrollee shall pay for bed stay for the first 15 cumulative days of hospitalization while EDHIC shall pay for the remaining 27 cumulative days per year.
SECONDARY CARE
1. Consultation with prescribed drugs from accredited Secondary Health Care facility.
2. Emergencies occurring outside the usual residence or accredited HCP
3. Admission for maximum of 15 days cumulative per year for medical admission and 20 days cumulative per year for surgical admissions.
4. Treatment and procedures that cannot be handled at primary level, but covered with the BMPHS.
5. HIV/AIDS
▪ Treatment of complications requiring admission
6. Pediatrics
▪ Treatment of Severe infections/Infestations-Respiratory infections, Urinary Tract Infections, diarrhoea disease with moderate to severe diseases such as Nephritis
▪ Management of severe anaemia requiring blood transfusion
▪ Management of neonatal Infections-Neonatal sepsis,
▪ Neonatal conditions such as birth asphyxia, neonatal jaundice, management of child from diabetic mothers
7. Internal medicine (Adult)
▪ Treatment of moderate to severe infections and infestations
–Management of severe malaria
–Management of meningitis, septicemia
–Management of complicated Respiratory Tract Infections
–Management of complicated typhoid fever
▪ Management of non-communicable diseases
–Management of complicated diabetes and hypertension
–Management of sickle cell disease
–Treatment of severe musculoskeletal conditions
–Treatment of cardiovascular conditions, renal diseases (such nephritis, nephrotic syndrome), Liver diseases (hepatitis, amoebic liver abscess).
–Management of severe anemia
▪ Treatment of snake bites (inclusive of serum)
8. Obstetrics and Gynaecology
▪ Basic and Comprehensive Emergency Obstetric Care
–Management of preterm/pre-labor Rupture of Membrane (P/PROM)
–Detection and management of hypertensive diseases in pregnancy
–Management of bleeding in pregnancy
–Management of postpartum hemorrhage
–Eclampsia
–Caesarian section
–Operative management for ectopic gestation
–Management of intra-uterine fetal death
–Management of puerperal sepsis
–Instrumental deliveries
–High risk deliveries – 1st deliveries, Beyond 4th deliveries, multiple deliveries, mal-positioning/mal-presentation and other complications.
▪ Gynecological Intervention
–Bartholin cystectomy (Marsupialization)
–Hysterectomy
–Myomectomies
–Colporrhaphies
–Vaginoplasty
–Ovarian cystectomy
9. Surgery
▪ Emergency Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Appendectomy
▪ Hernia repair
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
10. Dental care
11. Simple and surgical tooth extraction
12. Ophthalmology
▪ Eye problems, e.g. major trauma, pterygium, glaucoma, cataract extraction and other simple ophthalmological surgical procedures
▪ Removal of foreign bodies
▪ Refraction, including provision of spectacles not exceeding N5000
13. Ear, Nose & Throat (ENT)
ENT Clinical Procedures
▪ Ear Syringing
▪ Ear toileting
▪ Antral wash-out
▪ Foreign body removal from ear and nose
▪ Pure tone Audiometry
ENT Surgeries
Foreign body removal under GA
▪ Tonsillectomy
▪ Nasal Polypectomy
▪ Tracheostomy
▪ Adenoidectomy
▪ Myringotomy
14. Physiotherapy
▪ Post-traumatic rehabilitation
▪ Management of palsies within 15 days after initial treatment with a maximum of 5 sessions.
▪ Post-cerebrovascular accident therapy within 15 days with a maximum of 5 sessions.
15. Laboratory and Radiological investigations
▪ Genotype
▪ Urea/electrolyte/creatinine
▪ Bilirubin (total and conjugated)
▪ Ketone bodies
▪ Microscopy/culture/sensitivity-urine, blood, stool, sputum, wound, urethral, ear, eye, throat, aspirate, cerebrospinal fluid, endocervical swab, high vaginal swab.
▪ Occult blood in stool
▪ Skin snip for microfilaria
▪ Acid fast bacillus for Tuberculous Bacillus (sputum, blood)
▪ Gram stain
▪ Mantoux test
▪ Blood grouping/Cross matching
▪ Hepatitis B surface antibody HBsAg screening
▪ Confirmatory test for HIV
▪ Full Blood Count
▪ Platelets/ Reticulocyte count
▪ Platelets concentration
▪ Blood transfusion services for up to 3 pints of blood.
▪ Radiology–X-ray of chest, abdomen, skull & extremities, dental X-rays,
▪ Abdominopelvic & obstetric scan
▪ Other Services as may be listed from time to time
16. Ambulatory Services
Note: Additional services can be provided at the request of the tertiary institutions to address any additional identified needs. These extra services will be costed accordingly by EDHIC.
ii. Informal Sector Health PLAN B
Services covered under the informal sector health plan B shall include:
1. Health Promotion
▪ Health promotion: communicable & non-communicable diseases
▪ Hygiene, sanitation and environmental health
▪ Fight against stigma of patients with chronic diseases, e.g. chronic diseases, mental health, HIV, epilepsy
▪ Education on non-communicable diseases
▪ Dental health promotion
2. Preventive Health Services
▪ Health check-up
▪ Routine child health Examination-Routine health check for child over 28 days of age through 19 years of age.
▪ Routine newborn health Examination-Health examination for infant under 29 days of age
▪ General counselling and advice on Contraception-Family planning advice NOS/ Initial prescription of contraceptives
▪ Insertion of (intrauterine) contraceptive device
▪ HIV voluntary counseling & testing (VCT) and prevention of mother-to child transmission (PMTCT)
▪ Contact with and (suspected) exposure to HIV/PEP
3. Outpatient Services
▪ General Medical Consultation
– General Practice
– Dental
▪ Specialist
– Ophthalmology
– Obstetrics & Gynecology
– Ear, Nose, and Throat (ENT)
4. Internal Medicine
▪ Malaria
– Treatment of Plasmodium falciparum malaria
– Other severe and complicated malaria
– Uncomplicated febrile illness
5. Respiratory diseases
▪ Nasopharyngitis – Treatment of Acute nasopharyngitis [common cold]
▪ Respiratory distress – Airway management for respiratory distress
▪ Pneumonia – Antibiotic treatment of Pneumonia
▪ Asthma
▪ Prophylaxis (avoidance of allergens)
▪ Pharmacological management: bronchodilators & corticosteroids
▪ Nebulizer Therapy
▪ IV pharmacological therapy (Salbutamol & MgSO4)
▪ ENT Conditions
▪ Pharmaceutical Management
▪ Acute bronchitis
▪ Tuberculosis
▪ TB screening
▪ Preventive treatment using Anti-tuberculosis drugs
▪ TB treatment
▪ Influenza – Treatment of influenza due to identified seasonal influenza virus
6. Gastrointestinal Diseases
▪ Acute gastroenteritis – Oral and IV fluids
▪ Persistent diarrhea – Oral and IV fluids
▪ Bleeding esophageal varices
– pharmaceutical treatment
– Resuscitation with IV replacement
▪ Typhoid and paratyphoid fevers – Drug treatment of typhoid and Paratyphoid fevers
▪ Cholera – Treatment of Cholera including Antibiotic therapy
▪ Other bacterial, Viral and other specified intestinal infections
– Patient assessment
– Basic investigation (haematology, Microbiology, biochemistry, echography)
– Advanced investigation (pathology, endoscopy)
– Basic management (symptomatic management using drugs)
▪ Diabetes Mellitus
– Lifestyle modification (nutrition & physical activity)
– Insulin therapy
▪ Infectious and parasitic diseases
– Treatment of Helminthiasis – schistosomiasis
– Treatment of Helminthiasis-Other fluke infections
– Treatment of Helminthiasis-Taeniasis
– Treatment of Other cestode infections
– Treatment of Dracunculiasis-Guinea worm infection
– Treatment of Onchocerciasis
– Treatment of Hookworm diseases
– Treatment of Ascariasis-roundworm infection
– Treatment of Enterobiasis
– Treatment of Strongyloidiasis
– Treatment of Herpes viral [herpes simplex] infections
– Treatment of Varicella [chickenpox]
▪ Anaemia – Simple anaemia (not requiring blood transfusion)
▪ Snake Bites, Dog bites and other venomous bites Treatment for Toxic effect of contact with venomous animals
▪ Arthritis – Basic Treatment of arthritis
▪ Hypertension – Treatment and management of hypertensive disorders
7. Pediatrics
▪ Normal Newborn Care
– hypothermia of newborn
– Umbilical cord care
– Breastfeeding
– Eye prophylaxis
– Vitamin
– Anaemia prevention
– Infection prevention
– immunization against poliomyelitis
– immunization against yellow fever
– immunization against measles alone
– immunization against viral hepatitis
– immunization against tuberculosis [BCG]
▪ Prematurity Management of prematurity
– Incubator
– Warming/ Kangaroo Mother Care (KMC)
– Follow up with Supplementation of Multi Vitamins; Vit D, Calcuim and Iron Fe.
▪ Low birth weight (<2500g)
– Nutrition Breastfeeding
– Intravenous 10% Dextrose (IV D10%)
▪ Neonatal Infections:
– mild Intravenous antibiotics
– Antifungal and Antiviral
▪ Severe infection(Sepsis)
– Intravenous fluids
▪ Neonatal jaundice
– Intravenous fluids
▪ Birth Asphyxia
– hypothermia treatment
8. Maternal and Neonatal Services
▪ Screening for maternal illnesses
▪ Antenatal Care +Normal Delivery +Postnatal Care (6 weeks after delivery)
▪ Operative management of Ectopic pregnancy
▪ Single spontaneous delivery
▪ Multiple delivery
▪ Hemorrhage in early pregnancy
▪ Treatment of Excessive vomiting in pregnancy
▪ Treatment for Infections of genitourinary tract in pregnancy
▪ Diabetes in pregnancy, childbirth, and the puerperium
▪ Treatment of Malnutrition in pregnancy, childbirth and the puerperium
▪ Treatment for hypertensive disorders of pregnancy
▪ Treatment for anemia
▪ Iron & folic acid supplementation
▪ Tetanus and hepatitis vaccinations at the Dispensary Tetanus vaccination
▪ Counseling on family planning, birth and emergency preparedness
▪ Prevention & management of malaria during pregnancy
▪ Smoking cessation
▪ Screening & treatment of syphilis during pregnancy
▪ De-worming
▪ Treatment of urinary tract infections
▪ Prevention of pre-eclampsia: • Calcium • Low dose
▪ Treatment of eclampsia: magnesium sulfate
▪ Induction of labor to manage pre-labor rupture of membranes at term
▪ Prevention of respiratory distress syndrome (RDS) in preterm babies
▪ Monitoring labor
▪ Induction of labor for prolonged pregnancy
▪ Episiotomy
9. Basic Emergency Obstetric Care
▪ Manual removal of placenta
▪ Assisted vaginal delivery
10. Comprehensive Emergency Obstetric Care
▪ Caesarian-section including prophylatic antibiotics
11. HIV /AIDS
▪ Human immunodeficiency virus [HIV] disease management with (First Line ART)
▪ Human immunodeficiency virus [HIV] disease management with (Second Line ART)
▪ Treatment of complications requiring admission
12. STI
▪ Treatment of bacterial vaginosis
▪ Chlamydial infection
▪ Treatment of Gonorrhea
▪ Treatment of syphilis
▪ Treatment of Vulvo-Vagina Candidiasis
13. EYE CARE
▪ Full refraction and prescription of glasses
▪ Dispensing glasses < 5000 Naira once every two years
14. Glaucoma Services
▪ Glaucoma screening (IOP)
▪ Glaucoma Confirmation tests
▪ Prescription for Glaucoma
▪ Glaucoma Surgery
15. Conjunctivitis
▪ Diagnosing Conjunctivitis
▪ Treatment of Conjunctivitis (all)
16. DENTAL CARE
▪ Extraction (excluding third molar)
▪ Dental care limit Incision and Drainage
▪ Excisional Biopsy
▪ Incisional Biopsy
▪ Suturing
▪ Almalgam Filling
17. Laboratory investigations
▪ Hematology
▪ Hematocrit PCV
▪ Hemoglobin Hb
▪ Complete blood count FBC
▪ Blood typing
▪ Bleeding and clotting times
▪ Erythrocyte sedimentation rate (ESR)
▪ Biochemistry Proteinuria and Glucosuria
▪ RDT for malaria
▪ Drug monitoring assays
▪ Rapid pregnancy test
▪ Serum bilirubin
▪ Blood glucose
▪ Rapid plasma Reagin (RPR) for test for syphilis
▪ Rapid HIV test
▪ Rapid Hepatitis B & C tests
▪ Liver function tests
▪ Renal function test
▪ Urine M/C/S
▪ Swabs (Ear, Eye, Nose, Wound, HVS, Urethra, HVS, Endocervical, Pus)
▪ Aspirate M/C/S
▪ Sputum M/C/S
▪ AFBX3
▪ Seminal Fluid Analysis (SFA)
▪ VDRL
▪ Widal test
▪ Malaria Parasite
▪ Mantoux test
▪ Blood Culture
▪ Urine Microscopy
▪ Stool Microscopy
▪ CSF microscopy/ M/C/S
▪ Semen M/C/S
▪ Urinalysis
▪ Skin snip
▪ Skin scrapping
▪ Fecal occult blood
18. Radiological Services
▪ Chest X Ray (PA, Lateral)
▪ Chest X Ray (PA)
▪ X-ray Abdomen (Erect/supine)
▪ X-ray Abdomen (KUB)
▪ X-ray Ankle joint (AP,Lateral)
▪ X ray Arm (AP, Lateral)
▪ X-ray Cervical Spine (AP, Lateral)
▪ X-ray Elbow (AP, Lateral)
▪ X-ray Foot (AP, Lateral)
▪ X-ray Fore arm (AP, Lateral
▪ X-ray Hand (AP, Lateral)
▪ X-ray Hip Joint
▪ X-ray Knee Joint (AP, Lateral)
▪ X-ray leg (AP, Lateral)
▪ X-ray Neck (soft tissue/ AP Lateral)
▪ X-ray of the paranasal sinues
▪ X ray Pelvis
▪ X-ray Post nasal space
▪ X-ray Shoulder AP
▪ X-ray Shoulder AP, Lateral
▪ X-Ray Skull AP, Lateral
▪ X-ray Wrist (AP, Lateral)
▪ X-ray Lumbosacral spine
▪ Mammography
▪ Transvaginal USS
▪ Abdomino Pelvic
▪ Abdominal
▪ Pelvic USS
▪ Prostate USS
▪ Renal USS
▪ Obstetric USS
▪ Xray Femur
▪ Xray Humerus
19. General Surgical Procedure
▪ Minor Surgical Procedures
▪ Surgical Care Limit Minor wound debridement
▪ Evacuation of impacted faeces
▪ Drainage of paronychia
▪ Circumcision of male infants
▪ Relief of urinary retention
▪ Corrections of cases of simple polydactyly
▪ Appendectomy
▪ Hernia repair
▪ Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
▪ Oxygen Therapy (up to 3 sessions)
▪ Urinary Catherization
▪ Venous Cutdown
20. Emergency Care
▪ Establishing an intravenous line
▪ Simple tracheostomy
▪ Management of convulsion, coma, etc.
▪ Control of bleeding using pressure and simple suturing
▪ Assisted respiration (e.g. Ambu bag, etc.)
▪ Immobilization of fractures (using splints, neck collars, etc.)
▪ Aspiration of mucus plug to clear airways
▪ 2 sessions of dialysis
▪ High risk deliveries
▪ Hysterectomy
▪ Myomectomies
▪ Ovarian cystectomy
21. Ambulatory services
iii. Informal Sector Health PLAN C
Services covered under the informal sector health plan C shall include:
1. Health Promotion
▪ Health promotion: communicable & non-communicable diseases
▪ Hygiene, sanitation and environmental health
▪ Fight against stigma of patients with chronic diseases, e.g. chronic diseases, mental health, HIV, epilepsy
▪ Education on non-communicable diseases
▪ Dental health promotion
2. Preventive Health Services
▪ Health check-up
▪ Routine child health Examination-Routine health check for child over 28 days of age through 19 years of age.
▪ Routine newborn health Examination-Health examination for infant under 29 days of age
▪ General counselling and advice on Contraception-Family planning advice NOS/ Initial prescription of contraceptives
▪ Insertion of (intrauterine) contraceptive device
▪ HIV voluntary counseling & testing (VCT) and prevention of mother-to child transmission (PMTCT)
▪ Contact with and (suspected) exposure to HIV/Post Exposure Prophylaxis PEP
3. Outpatient Services
▪ General Medical Consultation
– General Practice
– Dental
▪ Specialist
– Ophthalmology
– Obstetrics & Gynecology
– Ear, Nose, and Throat (ENT)
4. Internal Medicine
▪ Malaria
– Treatment of Plasmodium falciparum malaria
– Other severe and complicated malaria
– Uncomplicated febrile illness
5. Respiratory diseases
– Nasopharyngitis – Treatment of Acute nasopharyngitis [common cold]
– Respiratory distress – Airway management for respiratory distress
– Pneumonia – Antibiotic treatment of Pneumonia
– Asthma
– Prophylaxis (avoidance of allergens)
– Pharmacological management: bronchodilators & corticosteroids
– Nebulizer Therapy
– IV pharmacological therapy (Salbutamol & MgSO4)
– ENT Conditions
– Pharmaceutical Management
– Acute bronchitis
– Tuberculosis
– TB screening
– Preventive treatment using Anti-tuberculosis drugs
– TB treatment
– Influenza – Treatment of influenza due to identified seasonal influenza virus
6. Gastrointestinal Diseases
▪ Acute gastroenteritis – Oral and IV fluids
▪ Persistent diarrhea – Oral and IV fluids
▪ Bleeding esophageal varices
– pharmaceutical treatment
– Resuscitation with IV replacement
▪ Typhoid and paratyphoid fevers – Drug treatment of typhoid and Paratyphoid fevers
▪ Cholera – Treatment of Cholera including Antibiotic therapy
▪ Other bacterial, Viral and other specified intestinal infections
– Patient assessment
– Basic investigation (hematology, echography, biochemistry
– Advanced investigation (pathology, endoscopy)
– Basic management (symptomatic management using drugs)
▪ Diabetes Mellitus
– Lifestyle modification (nutrition & physical activity)
– Insulin therapy
▪ Infectious and parasitic diseases
– Treatment of Helminthiasis – schistosomiasis
– Treatment of Helminthiasis-Other fluke infections
– Treatment of Helminthiasis-Taeniasis
– Treatment of other Cestode infections
– Treatment of Dracunculiasis-Guinea worm infection
– Treatment of Onchocerciasis
– Treatment of Hookworm diseases
– Treatment of Ascariasis – roundworm infection
– Treatment of Enterobiasis
– Treatment of Strongyloidiasis
– Treatment of Herpes viral [herpes simplex] infections
– Treatment of Varicella [chickenpox]
▪ Anaemia – Simple anaemia (not requiring blood transfusion)
▪ Snake Bites, Dog bites and other venomous bites Treatment for Toxic effect of contact with venomous animals
▪ Arthritis – Basic Treatment of arthritis
▪ Hypertension – Treatment and management of hypertensive disorders
7. Pediatrics
▪ Normal Newborn Care
– hypothermia of newborn
– Umbilical cord care
– Breastfeeding
– Eye prophylaxis
– Vitamin
– Anemia prevention
– Vitamin A supplement
– Infection prevention
– immunization against poliomyelitis
– immunization against yellow fever
– immunization against measles alone
– immunization against viral hepatitis
– immunization against tuberculosis [BCG]
▪ Prematurity Management of prematurity
– Incubator
– Warming/ Kangaroo Mother Care (KMC)
– Follow up with Supplementation of Multi Vitamins; Vit D, Calcuim and Fe.
▪ Low birth weight (<2500g)
– Nutrition Breastfeeding
– IV D10%
▪ Neonatal Infections:
– mild IV antibiotics
– Antifungal and Antiviral
▪ Severe infection(Sepsis)
– IV fluids
▪ Neonatal jaundice
– IV fluids
▪ Birth Asphyxia
– hypothermia treatment
8. Maternal and Neonatal Services
▪ Screening for maternal illnesses
▪ Antenatal Care +Normal Delivery +Postnatal Care Six weeks after delivery Antenatal Care
▪ Postnatal Care (6 weeks’ delivery)
▪ Operative management of Ectopic pregnancy
▪ Single spontaneous delivery
▪ Multiple delivery
▪ Hemorrhage in early pregnancy
▪ Treatment of Excessive vomiting in pregnancy
▪ Treatment for Infections of genitourinary tract in pregnancy
▪ Diabetes in pregnancy, childbirth, and the puerperium
▪ Treatment of Malnutrition in pregnancy, childbirth and the puerperium
▪ Treatment for hypertensive disorders of pregnancy
▪ Treatment for anemia
▪ Iron & folic acid supplementation
▪ Tetanus and hepatitis vaccinations at the Dispensary Tetanus vaccination
▪ Counseling on family planning, birth and emergency preparedness
▪ Prevention & management of malaria
▪ Smoking cessation
▪ Screening & treatment of syphilis
▪ De-worming
▪ Treatment of urinary tract infections
▪ Prevention of pre-eclampsia: • Calcium • Low dose
▪ Treatment of eclampsia: magnesium sulfate
▪ Induction of labor to manage pre-labor rupture of membranes at term
▪ Prevention of respiratory distress syndrome (RDS) in preterm babies
▪ Monitoring labor
▪ Induction of labor for prolonged pregnancy
▪ Episiotomy
9. Basic Emergency Obstetric Care
▪ Manual removal of placenta
▪ Assisted vaginal delivery
10. Comprehensive Emergency Obstetric Care
▪ C-section including prophylatic antibiotics
11. HIV /AIDS
▪ Human immunodeficiency virus [HIV] disease management with (First Line ART)
▪ Human immunodeficiency virus [HIV] disease management with (Second Line ART)
▪ Treatment of complications requiring admission
12. STI
▪ Treatment of bacterial vaginosis
▪ Chlamydial infection
▪ Treatment of Gonorrhea
▪ Treatment of syphilis
▪ Treatment of Vulvo-Vagina Candidiasis
13. EYE CARE
▪ Full refraction and prescription of glasses
▪ Dispensing glasses < 5000 Naira once every two years
14. Glaucoma Services
▪ Glaucoma screening (IOP)
▪ Glaucoma Confirmation tests
▪ Prescription for Glaucoma
▪ Glaucoma Surgery
15. Conjunctivitis
▪ Diagnosing Conjunctivitis
▪ Treatment of Conjunctivitis (all)
16. DENTAL CARE
▪ Extraction (excluding third molar)
▪ Dental care limit Incision and Drainage
▪ Excisional Biopsy
▪ Incisinal Biopsy
▪ Suturing
▪ Almalgam Filling
17. Laboratory investigations
▪ Hematocrit
▪ Hemoglobin
▪ Complete blood count
▪ Blood typing
▪ Bleeding and clotting times
▪ Erythrocyte sedimentation rate (ESR)
▪ Biochemistry Proteinuria and Glucosuria
▪ RDT for malaria
▪ Drug monitoring assays
▪ Rapid pregnancy test
▪ Serum bilirubin
▪ Blood glucose
▪ Rapid plasma reagin (RPR) for test for syphilis
▪ Rapid HIV test
▪ Rapid Hepatitis B & C tests
▪ Liver function tests
▪ Renal function test
▪ Urine M/C/S
▪ Swabs (Ear, Eye, Nose,Wound, HVS,Urethra, Endocervical swab, HVS, Pus)
▪ Aspirate M/C/S
▪ Sputum M/C/S
▪ Acid-Fast Bacillus AFBX3
▪ Seminal Fluid Analysis (SFA)
▪ VDRL
▪ Widal test
▪ Malaria Parasite
▪ Mantoux test
▪ Blood Culture
▪ Urine Microscopy
▪ Stool Microscopy
▪ CSF microscopy/ M/C/S
▪ Semen M/C/S
▪ Urinalysis
▪ Skin snip
▪ Skin scrapping
▪ Fecal occult blood
18 Radiological Investigation
▪ Radiology Chest X Ray (PA, Lateral)
▪ Chest X Ray (PA)
▪ X-ray Abdomen (Erect/supine)
▪ X-ray Abdomen (KUB)
▪ X-ray Ankle joint (AP,Lateral)
▪ X ray Arm (AP, Lateral)
▪ X-ray Cervical Spine (AP, Lateral)
▪ X-ray Elbow (AP, Lateral)
▪ X-ray Foot (AP, Lateral)
▪ X-ray Fore arm (AP, Lateral
▪ X-ray Hand (AP, Lateral)
▪ X-ray Hip Joint
▪ X-ray Knee Joint (AP, Lateral)
▪ X-ray leg (AP, Lateral)
▪ X-ray Neck (soft tissue/ AP Lateral)
▪ X-ray of the paranasal sinues
▪ X ray Pelvis
▪ X-ray Post nasal space
▪ X-ray Shoulder AP
▪ X-ray Shoulder AP, Lateral
▪ X-Ray Skull AP, Lateral
▪ X-ray Wrist (AP, Lateral)
▪ X-ray Lumbosacral spine
▪ Mammography
▪ Transvaginal USS
▪ Abdomino Pelvic
▪ Abdominal USS
▪ Pelvic USS
▪ Prostate USS
▪ Renal USS
▪ Breast USS
▪ Thyroid USS
▪ Scrotal
▪ Doppler Studies
▪ Obstetric USS
▪ Barium meal and follow through
▪ IVU
▪ Xray Femur
▪ Xray Humerus
▪ Xray Thoracolumbar
19. General Surgical Procedure
▪ Minor Surgical Procedures
▪ Surgical Care Limit Minor wound debridement
▪ Evacuation of impacted faeces
▪ Drainage of paronychia
▪ Circumcision of male infants
▪ Relief of urinary retention
▪ Corrections of cases of simple polydactyly
▪ Appendectomy
▪ Hernia repair
▪ Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
▪ Oxygen Therapy (up to 3 sessions)
▪ Urinary Catherization
▪ Venous Cutdown
▪ Treatment of mono arthritis using drugs contained in the EML
▪ Urethrovaginal Fistula
▪ Fractures requiring operative fixation
20. Emergency Care
▪ Establishing an intravenous line
▪ Simple tracheostomy
▪ Management of convulsion, coma, etc.
▪ Control of bleeding using pressure and simple suturing
▪ Assisted respiration (e.g. Ambu bag, etc.)
▪ Immobilization of fractures (using splints, neck collars, etc.)
▪ Aspiration of mucus plug to clear airways
▪ High risk deliveries
▪ Hysterectomy
▪ Myomectomies
▪ Ovarian cystectomy
21. Ambulatory Service
The Edo State Student Health Plan (ESSHP) is a social health insurance plan designed for students in tertiary institutions and it is funded by the contributions made by students alongside their tuition fees. It is a plan committed to ensuring access to qualitative healthcare service for students of tertiary institutions thereby promoting the health of students with a view to creating a conducive learning environment.
Members
Membership shall be open to full and Part-time students of public and private tertiary institutions in the state. Tertiary institutions are categorized as universities, colleges of Education, Polytechnics, other specialized colleges of Agriculture and Monotechnics, schools of Nursing, Midwifery and Health Technology, etc.
Contributions
Funds will be mobilized mainly from medical bills formerly charged by institutions alongside the tuition fees of students. This shall cover for the premium of the student. Contribution shall be made termly by the institution on behalf of her students.
Other sources of funds for ESSHP can include charitable or philanthropic organizations, corporate social responsibility initiatives, government mandates and subsidies.
Waiting period
There shall be no waiting period before students can access care in the assigned facilities. Access to care shall commence at the beginning of every new semester.
PRIMARY CARE
1. General consultation with prescribed drugs from accredited Public/Private Primary Health Care Facilities.
2. Health education for prevention of diseases.
▪ Family planning excluding provision of commodities (Safe period, pills, condoms, etc.)
▪ Dental health.
▪ HIV/AIDS/Tuberculosis/Malaria.
▪ Immunization.
▪ Vitamin A supplementation.
▪ Promotion of essential nutrients for children and pregnant women.
▪ Promotion of personal, domestic and environmental hygiene, etc.
▪ Precautionary measures against COVID 19.
3. Primary Care Surgery
▪ Minor Surgical Procedures: incision & drainage, suturing of lacerations, minor burns, simple abrasions.
▪ Minor wound debridement.
▪ Circumcision of male infants.
▪ Evacuation of impacted faeces.
▪ Relief of urinary retention.
▪ Primary eye care including treatment of:
–Conjunctivitis.
–Parasitic and allergic ailments.
–Simple contusion, abrasions etc.
4. Primary Care Pediatrics
▪ Child Welfare Services-Growth monitoring, Routine immunization as defined by the NPHCDA, Vitamin A supplementation, Nutritional advice and health education, etc.
▪ Management of uncomplicated malnutrition.
▪ Treatment for Helminthiasis.
▪ Treatment of common childhood illnesses such as malaria, diarrhea disease, schistosomiasis, upper Respiratory Tract Infections and uncomplicated Pneumonia.
▪ Treatment of uncomplicated Urinary Tract Infections.
▪ Treatment of Simple otitis media, pharyngitis.
▪ Childhood exanthemas, simple skin diseases/infestations and other viral illnesses such as mumps.
▪ Other febrile illnesses as may be listed from time to time.
▪ Treatment of anemia not requiring blood transfusion.
5. Primary Care Internal Medicine (Adult)
▪ Management of simple infections/infestations such as;
–Malaria
–Respiratory tract infections
–Urinary tract infections
–Gastroenteritis
–Primary ear, nose and throat infections
–Diarrheal diseases
–Enteritis/ typhoid fever
–Schistosomiasis
–Helminthiasis
–Skin infections/infestations such as chicken pox and fungal diseases e.g. Tinea versicolor, Malassezia furfur, Tinea capitis etc.
–Emergency management of bites and stings e.g. snakes, scorpions, bees, spiders etc. (Minus serum)
–Other uncomplicated bacteria, fungal, parasitic and viral infections and illnesses.
▪ Management of simple anemia (not requiring blood transfusion)
▪ Screening & referral for diabetes mellitus, hypertension and other chronic diseases.
▪ Treatment of simple arthritis and other minor musculoskeletal diseases.
▪ Routine management of sickle cell disease (excluding hydroxyl urea and pneumococcal immunization and Transcranial Doppler Examination.)
▪ Allergies.
6. HIV/AIDS/Sexual Transmitted Diseases
▪ Voluntary Counseling and Testing (VCT)
7. Primary Care Mental Health Management
▪ Anxiety neurosis
▪ Psychosomatic illnesses
▪ Insomnia
▪ Identification of drug abuse
▪ Other illnesses as may be listed from time to time by NPHCDA.
8. Primary Care Maternal, Neonatal and Child Health (MNCH) Services
▪ Antenatal care
–Routine antenatal clinic
–Routine drugs to cover duration of pregnancy
–Routine urine and blood tests
–Referral services for complicated cases
▪ Postnatal services
–All eligible livebirths up to 6 weeks from date of birth. (Cord care, Eye care, Management of simple neonatal infections)
▪ Delivery services
–Spontaneous Vaginal Delivery by skilled attendant including repair of birth injuries and episiotomy.
–Essential drugs for Emergency Obstetric care (EmOC)
9. Primary Care Emergency Services
▪ Understand the use of simple ABCD protocols and prioritize lifesaving over cause finding.
▪ Airway assessment and use of airway adjuncts.
▪ Use of basic means of airway aspiration and clearance.
▪ Breathing assessment and use of simple equipment to aid and monitor breathing like ambu bags.
▪ Pulse oximetry
▪ Control of bleeding using compression dressing
▪ Assessment of hemodynamic stability
▪ Establishment of intravenous line and venous cut down
▪ Fluid resuscitation
▪ Basic cardiopulmonary resuscitation
▪ Use of early warning signs
▪ Recognition of signs requiring prompt referral particularly in children, pregnant women and the elderly.
▪ Assessment and basic management of the unconscious patient
▪ Suturing of small lacerations where no resuscitation is required.
▪ Immobilization of fractures and cervical spine using splints
10. Basic laboratory investigations
▪ Urinalysis
▪ Haemoglobin (Hb) / Packed Cell Volume (PCV)
▪ Stool microscopy
▪ Urine microscopy
▪ Pregnancy Test
▪ Blood Glucose Test
Note: The primary healthcare facility of the enrollee shall pay for bed stay for the first 10 cumulative days of hospitalization while the Commission shall pay for the remaining 10 cumulative days per year in secondary healthcare facilities.
SECONDARY CARE
1. Consultation with prescribed drugs from accredited Secondary Health Care facility.
2. Emergencies occurring outside the usual residence or accredited HCP.
3. Admission for maximum of 15 days cumulative per year for medical admission and 20 days cumulative per year for surgical admissions.
4. Treatment and procedures that cannot be handled at primary level, but covered with the BMPHS.
5. HIV/AIDS
▪ Treatment of complications requiring admission.
6. Pediatrics
▪ Treatment of Severe infections/Infestations-Respiratory infections, Urinary Tract Infections, diarrhoeal disease with moderate to severe dehydration, enteric fever, severe malaria, septicemia, meningitis, severe measles.
▪ Management of childhood non-communicable diseases such as Nephritis.
▪ Management of severe anaemia requiring blood transfusion
▪ Management of neonatal Infections-Neonatal sepsis.
▪ Neonatal conditions such as birth asphyxia, neonatal jaundice, management of child from diabetic mothers.
7. Internal medicine (Adult)
▪ Management of moderate to severe infections and infestations.
–Management of severe malaria.
–Management of meningitis, septicemia.
–Management of complicated Respiratory Tract Infections.
–Management of complicated typhoid fever.
▪ Management of non-communicable diseases.
–Management of complicated diabetes and hypertension
–Management of sickle cell disease.
–Treatment of severe musculoskeletal conditions
–Treatment of cardiovascular conditions, renal diseases (such nephritis, nephrotic syndrome), Liver diseases (hepatitis, amoebic liver abscess).
–Management of severe anemia.
▪ Treatment of snake bites (inclusive of serum)
8. Obstetrics and Gynecology
▪ Basic and Comprehensive Emergency Obstetric Care
–Management of preterm/pre-labor Rupture of Membrane (P/PROM)
–Detection and management of hypertensive diseases in pregnancy
–Management of bleeding in pregnancy
–Management of postpartum hemorrhage
–Eclampsia
–Caesarian section
–Operative management for ectopic gestation
–Management of intra-uterine fetal death
–Management of puerperal sepsis
–Instrumental deliveries
–High risk deliveries –1st deliveries, Beyond fourth deliveries, multiple deliveries, mal-positioning / mal-presentation and other complications.
▪ Gynecological Intervention
–Bartholin cystectomy (Marsupialization)
–Hysterectomy
–Myomectomies
–Colporrhaphies
–Vaginoplasty
–Ovarian cystectomy
9. Surgery
▪ Emergency Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Appendectomy
▪ Hernia repair
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
10. Dental care- Simple and surgical tooth extraction
11. Ophthalmology
▪ Eye problems, e.g. major trauma, pterygium, glaucoma, cataract extraction and other simple ophthalmological surgical procedures.
▪ Removal of foreign bodies.
▪ Refraction, including provision of spectacles not exceeding N5000.
12. Ear, Nose & Throat (ENT) Clinical Procedures
▪ Ear Syringing
▪ Ear toileting
▪ Antral wash-out
▪ Foreign body removal from ear and nose
▪ Pure tone Audiometry
ENT Surgeries
▪ Foreign body removal under General Anaesthesia (GA)
▪ Tonsillectomy
▪ Nasal Polypectomy
▪ Tracheostomy
▪ Adenoidectomy
▪ Myringotomy
13. Physiotherapy
▪ Post-traumatic rehabilitation
▪ Management of palsies within 15 days after initial treatment with a maximum of 5 sessions.
▪ Post-cerebrovascular accident therapy within 15 days with a maximum of 5 sessions.
14. Laboratory/ Diagnostic Radiology investigations
▪ Genotype
▪ Electrolyte/Urea/Creatinine
▪ Bilirubin (total and conjugated)
▪ Ketone bodies
▪ Microscopy/culture/sensitivity- urine, blood, stool, sputum, wound, urethral, ear, eye, throat, aspirate, cerebrovascular spinal fluid, endoscopy cervical swab, high vaginal swab.
▪ Occult blood in stool
▪ Skin snip for microfilaria
▪ Acid fast bacillus for Tubercle Bacillus (sputum, blood)
▪ Gram stain
▪ Mantoux test
▪ Blood group/Cross match
▪ Hepatitis B surface antibody screening
▪ Confirmatory test for HIV
▪ Full Blood Count
▪ Platelets/ Reticulocyte count
▪ Platelets concentration
▪ Blood transfusion services for up to 3 pints of blood.
▪ Radiology–X-ray of chest, abdomen, skull & extremities, dental X-rays,
▪ Abdominopelvic & obstetric scan
▪ Gene Expert for detection of Mycobacterium Tuberculosis.
▪ Other Services as may be listed from time to time
15. Ambulatory services
Note: Additional services can be provided at the request of the tertiary institutions to address any additional identified needs. These extra services will be costed accordingly by the Commission.
The Enhanced Private Health Plan is a health plan designed to cater for the health needs of resident who wishes to access additional healthcare Services not covered in the other Health Plans of the Scheme.
Member
Membership shall be voluntary and shall cover interested individuals, families, interested employers and employees.
Contributions
There shall be no co-payment between employees and employers in this plan. Enrollee shall pay the full actuarially determined premium for this health plan. Employers who wish to purchase this health plan for their staff shall pay the full actuarially determined premium for this health plan.
Waiting Period
There shall be an administrative waiting period of 30 days before beneficiaries under this health plan can access care from health facilities assigned to them.
Registration
Registration of enrollees shall be carried out by the Commission.
Insurance ID cards shall be issued to Beneficiaries by the Commission.
Benefit Package
Benefit Package covered under the Enhanced Private Health Plan shall include;
PRIMARY CARE
1. Health Promotion
▪ Health promotion: communicable & non-communicable diseases.
▪ Hygiene, sanitation and environmental health.
▪ School Health.
▪ Fight against stigma of patients with chronic diseases, e.g. chronic diseases, mental health, HIV, epilepsy
▪ Education on non-communicable diseases
▪ Dental health promotion
2. Preventive Health Services
▪ Health check-up
▪ Routine child health Examination-Routine health check for child over 28 days of age through 19 years of age.
▪ Routine newborn health Examination-Health examination for infant under 29 days of age
▪ General counselling and advice on Contraception-Family planning advice NOS/ Initial prescription of contraceptives.
▪ Insertion of (intrauterine) contraceptive device
▪ Surveillance of Contraceptive drug
▪ HIV voluntary counseling & testing (VCT) and prevention of mother-to child transmission (PMTCT)
▪ Contact with and (suspected) exposure to HIV/PEP.
▪ Precautionary measures against COVID 19.
3. Outpatient Services
▪ General Medical Consultation
– General Practice
– Dental
▪ Specialist
– Ophthalmology
– Obstetrics & Gynecology
– Ear, Nose, and Throat (ENT)
4. Internal Medicine
▪ Malaria
– Treatment of Plasmodium falciparum malaria
– Other severe and complicated malaria
– Uncomplicated febrile illness
5. Respiratory diseases
▪ Nasopharyngitis – Treatment of Acute nasopharyngitis [common cold]
▪ Respiratory distress – Airway management for respiratory distress
▪ Pneumonia – Antibiotic treatment of Pneumonia
▪ Asthma
▪ Oxygen therapy
▪ Prophylaxis (avoidance of allergens)
▪ Pharmacological management: bronchodilators & corticosteroids
▪ Nebulizer Therapy
▪ IV pharmacological therapy (Salbutamol & MgSO4)
▪ ENT Conditions
▪ Pharmaceutical Management
▪ Surgical Interventions
▪ Acute bronchitis
▪ Simple and Mucopurulent Chronic Bronchitis
▪ Tuberculosis
▪ TB screening
▪ Preventive treatment using Anti-tuberculosis drugs
▪ TB treatment
▪ Influenza – Treatment of influenza due to identified seasonal influenza virus
6. Gastrointestinal Diseases
▪ Acute gastroenteritis – Oral and IV fluids
▪ Persistent diarrhea – Oral and IV fluids
▪ Bleeding esophageal varices
– pharmaceutical treatment
– Resuscitation with IV replacement
– Endoscopic Injection Sclerotherpy
▪ Typhoid and paratyphoid fevers – Drug treatment of typhoid and Paratyphoid fevers
▪ Cholera – Treatment of Cholera including Antibiotic therapy
▪ Other bacterial, Viral and other specified intestinal infections
– Patient assessment
– Basic investigation (Haematology, Medical Microbiology, Biochemistry, echography)
– Advanced investigation (Pathology, Endoscopy)
– Basic management (symptomatic management using drugs)
– Advanced management (drugs, endoscopic and surgical interventions)
▪ Diabetes Mellitus
– Lifestyle modification (nutrition & physical activity)
– Insulin therapy
▪ Infectious and parasitic diseases
– Treatment of Helminthiasis – schistosomiasis
– Treatment of Helminthiasis-Other fluke infections
– Treatment of Helminthiasis-Taeniasis
– Treatment of Other cestode infections
– Treatment of Dracunculiasis-Guinea worm infection
– Treatment of Onchocerciasis
– Treatment of Hookworm diseases
– Treatment of Ascariasis -roundworm infection
– Treatment of Enterobiasis
– Treatment of Strongyloidiasis
– Treatment of Herpes viral [Herpes simplex] infections
– Treatment of Varicella [chickenpox]
▪ Anaemia – Simple Anaemia (not requiring blood transfusion)
▪ Snake Bites, Dog bites and other venomous bites Treatment for Toxic effect of contact with venomous animals
▪ Arthritis – Basic Treatment of arthritis
▪ Hypertension – Treatment and management of hypertensive disorders
7. Pediatrics
▪ Normal Newborn Care
– hypothermia of newborn
– Umbilical cord care
– Breastfeeding
– Eye prophylaxis
– Vitamin
– Anemia prevention
– Vitamin A supplement
– Infection prevention
– immunization against poliomyelitis
– immunization against yellow fever
– immunization against measles alone
– immunization against viral hepatitis
– immunization against tuberculosis [BCG]
▪ Prematurity Management of prematurity
– Incubator
– Warming/ Kangaroo Mother Care (KMC)
– Antibiotic therapy
– Follow up with Supplementation of Multi Vitamins; Vit D, Calcuim and Iron.
▪ Low birth weight (<2500g)
– Nutrition Breastfeeding
– Warming/ Kangaroo Mother Care/Incubator
– Intravenous 10% Dextrose (IV D10%)
– Oxygen therapy (if Necessary)
▪ Neonatal Infections:
– mild Intravenous antibiotics
– Antifungal and Antiviral
▪ Severe infection(Sepsis)
– Intravenous fluids
– Oxygen therapy
– Mechanical Ventilator support
▪ Neonatal jaundice
– Intravenous fluids
– Phototherapy
– Exchange transfusion
▪ Birth Asphyxia
– hypothermia treatment
– Endotracheal Intubation
8. Maternal and Neonatal Services
▪ Screening for maternal illnesses
▪ Antenatal Care +Normal Delivery +Postnatal Care Six weeks after delivery Antenatal Care
▪ Postnatal Care (6 weeks’ delivery)
▪ Operative management of Ectopic pregnancy
▪ Single spontaneous delivery
▪ Multiple delivery
▪ Hemorrhage in early pregnancy
▪ Treatment of Excessive vomiting in pregnancy
▪ Treatment for Infections of genitourinary tract in pregnancy
▪ Diabetes in pregnancy, childbirth, and the puerperium
▪ Treatment of Malnutrition in pregnancy, childbirth and the puerperium
▪ Treatment for hypertensive disorders of pregnancy
▪ Treatment for anemia
▪ Iron & folic acid supplementation
▪ Tetanus and hepatitis vaccinations at the Dispensary Tetanus vaccination
▪ Counseling on family planning, birth and emergency preparedness
▪ Prevention & management of malaria
▪ Smoking cessation
▪ Screening & treatment of syphilis
▪ De-worming
▪ Treatment of urinary tract infections
▪ Prevention of pre-eclampsia: • Calcium • Low dose
▪ Treatment of eclampsia: magnesium sulfate
▪ Induction of labor to manage pre-labor rupture of membranes at term
▪ Prevention of respiratory distress syndrome (RDS) in preterm babies
▪ Monitoring labor
▪ Induction of labor for prolonged pregnancy
▪ Episiotomy
▪ Pudendal Anesthesia
9. Basic Emergency Obstetric Care
▪ Manual removal of placenta
▪ Assisted vaginal delivery
▪ Removal of Retained products
10. Comprehensive Emergency Obstetric Care
▪ Caesarian-section including prophylatic antibiotics
▪ Management of post-partum hemorrhage including blood transfusion
11. HIV /AIDS
▪ Human immunodeficiency virus [HIV] disease management with (First Line ART)
▪ Human immunodeficiency virus [HIV] disease management with (Second Line ART)
▪ Treatment of complications requiring admission
12. Sexually Transmitted Infections STI
▪ Treatment of bacterial vaginosis
▪ Chlamydial infection
▪ Treatment of Gonorrhea
▪ Treatment of syphilis
▪ Treatment of Vulvo-Vagina Candidiasis
13. Eye Care
▪ Full refraction and prescription of glasses
▪ Dispensing glasses < 5000 Naira once every two years
14. Glaucoma Services
▪ Glaucoma screening (IOP)
▪ Glaucoma Confirmation tests
▪ Prescription for Glaucoma
▪ Glaucoma Surgery
15. Conjunctivitis
▪ Diagnosing Conjunctivitis
▪ Treatment of Conjunctivitis (all)
16. Dental Care
▪ Extraction (excluding third molar)
▪ Dental care limit Incision and Drainage
▪ Excisional Biopsy
▪ Incisional Biopsy
▪ Suturing
▪ Almalgam Filling
17. Laboratory investigations
▪ Hematocrit
▪ Hemoglobin
▪ Complete blood count
▪ Blood typing
▪ Bleeding and clotting times
▪ Erythrocyte sedimentation rate (ESR)
▪ Biochemistry Proteinuria and Glucosuria
▪ Rapid Diagnostic Test (RDT) for malaria
▪ Drug monitoring assays
▪ Rapid pregnancy test
▪ Serum bilirubin
▪ Blood glucose
▪ Rapid plasma reagin (RPR) for test for syphilis
▪ Rapid HIV test
▪ Rapid Hepatitis B & C tests
▪ Liver Function Tests (LFT)
▪ Renal Function Test
▪ Biochemistry Urine M/C/S
▪ Swabs (Ear, Eye, Nose, Wound, High Vaginal Swab, Urethra, Endocervical, Pus )
▪ Aspirate M/C/S
▪ Cerebrospinal Fluid Microscopy/ M/C/S
▪ Sputum M/C/S
▪ Acid Fast Bacillus AFBX3
▪ Seminal Fluid Analysis (SFA)
▪ VDRL
▪ Widal Test
▪ Malaria Parasite
▪ Mantoux test
▪ Blood Culture
▪ Urine Microscopy
▪ Stool Microscopy
▪ Semen m/c/s
▪ Urinalysis
▪ Skin snip
▪ Skin scrapping
▪ Fecal occult blood
18. Radiological Investigations
▪ Chest X Ray (PA, Lateral)
▪ Chest X Ray (PA)
▪ X-ray Abdomen (Erect/supine)
▪ X-ray Abdomen (KUB)
▪ X-ray Ankle joint (AP, Lateral)
▪ X ray Arm (AP, Lateral)
▪ X-ray Cervical Spine (AP, Lateral)
▪ X-ray Elbow (AP, Lateral)
▪ X-ray Foot (AP, Lateral)
▪ X-ray Fore arm (AP, Lateral
▪ X-ray Hand (AP, Lateral)
▪ X-ray Hip Joint
▪ X-ray Knee Joint (AP, Lateral)
▪ X-ray leg (AP, Lateral)
▪ X-ray Neck (soft tissue/ AP Lateral)
▪ X-ray of the paranasal sinuses
▪ X ray Pelvis
▪ X-ray Post nasal space
▪ X-ray Shoulder AP
▪ X-ray Shoulder AP, Lateral
▪ X-Ray Skull AP, Lateral
▪ X-ray Wrist (AP, Lateral)
▪ X-ray Lumbosacral spine
▪ Mammography
▪ Transvaginal USS
▪ Abdomino-Pelvic
▪ Abdominal
▪ Pelvic USS
▪ Prostate USS
▪ Renal USS
▪ Breast USS
▪ Thyroid USS
▪ Scrotal
▪ Doppler Studies
▪ Obstetric USS
▪ X-ray Femur
▪ X-ray Humerus
19. General Surgical Procedure
▪ Minor Surgical Procedures
▪ Surgical Care Limit Minor wound debridement
▪ Evacuation of impacted faeces
▪ Drainage of paronychia
▪ Circumcision of male infants
▪ Relief of urinary retention
▪ Corrections of cases of simple polydactyly
▪ Appendectomy
▪ Hernia repair
▪ Laparotomy for any cause
▪ Intestinal Resection & Anastomosis
▪ Hydrocelectomy
▪ Management of Testicular Torsion
▪ Thyroidectomy
▪ Management of Fractures excluding internal fixation
▪ Oxygen Therapy (up to 3 sessions)
▪ Urinary Catherization
▪ Venous Cutdown
▪ Treatment of mono arthritis using drugs contained in the Emergency Medicine List
▪ Urethrovaginal Fistula
▪ Fractures requiring operative fixation
20. Emergency Care
▪ Establishing an intravenous line
▪ Simple tracheostomy
▪ Management of convulsion, coma, etc.
▪ Control of bleeding using pressure and simple suturing
▪ Assisted respiration (e.g. Ambu bag, etc.)
▪ Immobilization of fractures (using splints, neck collars, etc.)
▪ Aspiration of mucus plug to clear airways
▪ 2 sessions of dialysis
▪ High risk deliveries
▪ Hysterectomy
▪ Myomectomies
▪ Ovarian cystectomy
21. Ambulatory Services