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Treatment cost of spinal cord injury is beyond reach for many Nigerians – Expert

NHIS, HMOs exempt spinal cord surgeries from their benefits

MANY Nigerians with spinal cord-related injuries could not afford the cost of medical expenses due to their low financial capability.

Abdul’aziz Ibrahim, acting chairman of persons with spinal cord injuries in Kano said this during the inauguration of the Northern branch of Arewa Spinal Cord Injury Society of Nigeria (ASCIN) that held at Aminu Kano Teaching Hospital (AKTH) on Monday.

The association that was formed to support Nigerians passing through the ailment comes into being when the National Health Insurance Scheme (NHIS) made no provision for the treatment and the people could not afford the medical expenses.

According to the College of Medicine of the University of Ibadan, spinal cord injury causes permanent loss of strength, sensation and function below the site of the injury.

While treatments include drugs to reduce symptoms and surgery to stabilise the spine, people with spinal cord injuries also need rehabilitation and assistive devices to lead productive, independent lives.

But the Nigeria NHIS seems to be overlooking how to support people living with the spine diseases. In its operational guidelines that identified the benefits provided by the scheme, spine surgery is not listed among the benefits.

Also, the Magnetic Resonance Imaging (MRI) that creates a picture of bones, soft tissues and organs giving the doctor a picture of the spinal cord and the discs of the spine is excluded partially from the benefit.

“High technology investigations e.g. CT scan, MRI: the HMO would pay 50% of cost,” stated NHIS.

This means that health maintenance organisation (HMO) supports is partial for the medical laboratory test of Nigerians with a challenged spine by paying half of the total cost.

The NHIS listed 60 HMOs on its website. Seven private insurance companies checked by the ICIR did not include spinal cord care, particularly spine surgery, among their benefits. The Hygeia HMO plan for a standard family of four exempted medical services for spinal cord injuries. The MRI scan was among the exclusion list.

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Clearline International Limited also did not list spinal cord treatment in its plan for family and individual policy.  Mediplan Health Care in its plan “Enhanced Health Plan” excluded MRI scan out of the benefits to enjoy and physiotherapists sessions were limited to 10 sessions.

None of the plans for Mediplan has provision for spinal cord surgery. Surgical operations for the spinal cord is also excluded for all plans of the United Healthcare International.

AIICO Multishield Limited, International Health Management Services, Ronsberger Nigeria Limited also exempted spinal cord surgeries in the services provided to insured people.

Speaking at the launching of the spinal cord care organisation in Kano, Ibrahim described the disease a painful experience that he said awareness needed to be created to draw the right attention in order to secure aid and relief for the patients.

“You would not understand our condition unless you are also suffering from the same ailment. This is the ailment that makes a person live a miserable life.

“Its expenses are exorbitant while about 70 per cent of the patients are from poor families. They cannot afford the medical expenses.

MRI scanning alone is N65,000 to N75,000; surgery is about N1.5 million,” he said.

Ibrahim urged the Federal government to establish rehabilitation centres for its members in the  North as he said such facility was not in the region.

Physiotherapist Mbamalu Chibuike Chizoba noted how quality longterm intensive physical rehabilitation is important in the management of spinal cord injury.

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