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NHIS & The Lifestyle Medicine Clinic

The National Health Insurance Scheme (NHIS) was established by Decree 35 of 1999, now caps Parliamentary Act 35 of 1999. Participation in the scheme is by Public Private Partnership (PPP) with standard NHIS operational guidelines (Ed. 2012).

NHIS operation began in UPTH in 2004. Initial services were provided at the staff clinic headed by Dr. Vincent Roland, during Dr. Paul Dienye’s tenure as Head of Family Medicine Department. The staff clinic had metamorphosed into the current NHIS clinic and in 2009, Dr. Mrs. Obianma Onya who was posted to NHIS clinic was appointed Head of Unit by the Head of Department at that time Dr. Alex Akani.

In 2014 when Dr. Onya became Head of Family Medicine Department, Dr. Kaine Diete-Spiff was appointed by her to be Head of NHIS Unit. Hitherto, NHIS was part of the Family Medicine Revolving Fund and as such, the department was responsible for the day-to-day running of the Unit. In 2016, with the creation of the NHIS Revolving Fund, Dr. Kaine Diete-Spiff became the first Project Manager of NHIS- a position she held until December 2017. In January, Dr. Adjugah Joshua was appointed Head and Project Manager of NHIS.

Administratively, the unit still remains part and parcel of Family Medicine Department and is run by Consultants and Residents of the department in line with accreditation requirements.

The NHIS clinic is the first port of call or gateway into the NHIS services of UPTH which attends to all primary care cases under health insurance while coordinating the referral to secondary and tertiary healthcare providers in UPTH. The NHIS UNIT interfaces with clinical/laboratory/radiological Departments/Units and Management of UPTH. The unit regularly interacts with the Health Maintenance Organizations (HMOs) and the NHIS regulators on NHIS activities/functions. It also oversees the business wing of NHIS in and outside UPTH.

The Lifestyle Medicine Clinic was established in January 2018 by UPTH management as part of the staff welfare initiative conceived by the Medical and Dental Consultants of Nigeria (MDCAN) Health Promotion Committee headed by Dr. Obianma Onya who is incidentally the current Deputy Chairman Medical Advisory Committee (DCMAC) in charge of NHIS and SERVICOM. This is the second Lifestyle Medicine clinic to be established in a public health institution in Nigeria- a feat that was recognized and commended by the Lifestyle Medicine Global Alliance (LMGA) at the 2018 Lifestyle Medicine Conference organized by the American College of Lifestyle Medicine (ACLM) which held at Indianapolis, USA.

PAST & PRESENT HEADS OF UNIT AND DESK OFFICERS IN THE NHIS UNIT

S/N PERIOD HEAD NHIS DESK OFFICER
1 2004 – 2009 Dr. VINCENT ROLAND Mr. IHUNWO.
2 2009 – 2014 Dr. OBIANMA ONYA Mr. IHUNWO.
3 2014– 2017 Dr. KAINE DIETE-SPIFF Ms. AKOR PATIENCE.
S/N PERIOD HEAD/PROJECT MANAGER NHIS DESK OFFICER
1  2016 – 2017 Dr. (MRS) DIETE-SPIFFKAINE. Mr. OLOYE JOSEPH.
2 JAN 2018 TILL DATE Dr. ADJUGAH JOSHUA U. Mr. IGBAGIRI PATRICK I.

The NHIS enrollees’ profile of the hospital is 13,044 as at the current September/October 2018 NHIS register, with 36 HMOs. It also deals with private healthcare plan through the HMOs and private retainership with NNPC, CBN etc.

The NHIS UNIT is under the administration of Family Medicine Department of UPTH, and the consulting doctors are Family Physicians who by training deal with illnesses irrespective of the disease entity, age or gender of the patients.

The NHIS Unit has a total of 35 personnel and their cadres include;
6 Doctors (2 Consultants & 4 Family Medicine Residents), 3 Pharmacists, 2 Nurses, 2 Nursing Assistants, 9 Administrative personnel, 4 Medical Records personnel, 4 Accounts personnel, 2 personnel from the N-Power Programme, and 3 Ad hoc staff.   

DR ADJUGAH JOSHUA U.
HEAD/PROJECT MANAGER: NHIS UNIT.

For more details on the scope of work see UPTH Service Charter.
For Protocol of service; see UPTH Service Charter.

THE LIFESTYLE MEDICINE CLINIC

Lifestyle Medicine is a branch of evidence-based medicine in which comprehensive lifestyle changes (including nutrition, physical activity, stress management, social support, and environmental exposures) are used to prevent, treat and reverse the progression of chronic diseases by addressing their underlying causes.

Lifestyle medicine interventions include health risk assessment screening, health behaviour change counseling and clinical application of lifestyle modification.

History:
The lifestyle Medicine clinic of UPTH began in January 2018. It was borne out of the need to tackle the menace of an increasing prevalence of Non-Communicable Diseases(NCDs) by a paradigm shift to treating the cause of the disease in line with global trend.

It is domiciled within the NHIS clinic and runs weekly offering its services predominantly to NHIS clients through periodic medical assessment with a view to prevention, treatment, and reversal of NCDs among these clients.

Protocol:
The clients access services in the clinic through the NHIS records. They are attended to by the nurse where their vital signs and anthropometric measurements are taken. They are directed to the attending physician where they are first educated on the importance of lifestyle medicine. They also undergo health risk assessment screening which helps unveil their individual areas of need for lifestyle modification. Necessary investigations are requested for. During subsequent scheduled visits, results of investigations are reviewed and patient’s areas of need are specifically addressed. This includes exercise prescription, nutrition counseling, stress management, and social support.

Staff Strength:
The clinic is run by Family Physicians with a special interest in Lifestyle Medicine. It is headed by Dr(Mrs) O.N. Onya, a Chief Consultant Family Physician with a special interest in Lifestyle Medicine. She is a member of the American College of Lifestyle Medicine and the Vice President (Membership) of the Society of Lifestyle Medicine Association of Nigeria.

The other Physician is Dr. (Mrs.) A. John, a Fellow of West African College of Physician (Family Medicine). She is a member of the American College of Lifestyle Medicine and Society of Lifestyle Medicine Association of Nigeria.

Since the clinic is domiciled in the NHIS clinic, other staff are the NHIS staff.

Prospect:
The Lifestyle Medicine clinic aspires to be a stand-alone clinic serving both walk-in and NHIS clinic patients with an independent revolving fund.

The clinic looks forward to greater interdepartmental collaboration.

It looks forward to a team of trained healthcare professionals undertaking its activities. These include a nurse, exercise physiologist, nutrition counselor all trained in lifestyle medicine.

The infrastructural needs of the clinic include a one-stop facility with a clinic area, laboratory, gym area, culinary kitchen. Further services would include disease reversal programmes, Exercise in the workplace program etc.

For more details on the scope of work see UPTH Service Charter.
For Protocol of service; see UPTH Service Charter.

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