FG signs MOU for national emergency medical service operation

The Federal Ministry of Health (FMOH), has signed a multi-sectoral Memorandum of Understanding (MOU) and launched the Implementation Manual, for operationalizing the National Emergency Medical Service and Ambulance System (MEMSAS) to rescue accident emergencies on the highways.

The Minister of Health, Dr Osagie Ehanire, at the public signing on Monday in Abuja, disclosed NEMSAS was the operational arm of the third disbursement gateway, designated in the National Health Act (NHA), with five per cent of the Basic Healthcare Provision Fund for Emergency Medical Treatment meant to provide urgent health service to Nigerians

NEMSAS is the third Basic Health Care Provision Fund (BHCPF), gateway, which addresses a serious weakness in Nigerians health system, which makes no provision for physical and financial access to First Aid and healthcare, in case of life-threatening emergencies of any type.

Ehanire further posited that such intervention and the concept adopted were novel in the country’s health system, being first of their kind at national scale and because of the innovative features, designed to minimize the cost of operation and increased coverage.

“Private Sector is expected to bring in organizational acumen and a common understanding of program delivery as a public service initiative to be delivered at cost.

“The idea was to pool existing material and human resource assets of both public and private providers, to a combined platform, using ambulances and hospital urgent care centres, on a fee-for-service basis.

“The most cost-effective way to optimize limited resources to operate the service at scale, and also to grow the five per cent of Basic Healthcare Fund by sourcing for additional income through donations and contributions, to a National Fund, as service spreads around the country,” he explained.

Ehanire pointed out that in all these cases, medical help comes at the call of 112, a number provided and maintained by the Nigerian Communication Commission in 24 states and counting.

“The call is a free-of-charge public service for the sick or injured and avoids delay in accessing treatment or transport. It is relayed to manned EOC (Emergency Operations Centre) of every State and the FCT.

“Fee-for-service payment to service providers was by special agreement with National Health Insurance Scheme (NHIS), on their well established electronic payment platform, a unique intersectoral collaboration that allows NEMSAS to electronically reimburse accredited service providers registered with both NHIS and NEMSAS for service rendered since NHIS has the profile of most hospitals in Nigeria and is uploading ambulance Service provider profiles”.

“There will be the capacity to electronically locate, track and verify ambulance movement with a software promised by a Partner,” he explained.

Ehanire maintained that apart from engagement with the Private Medical Sector, EMTC was built around collaboration with state ministries of health, relevant federal ministries, agencies, departments, civic society organisations and even outside Associations, all with a common interest or stake in providing medical help to persons, whose lives were at risk, whether due to severe injury, sudden illness or health distress related to pregnancy, infection or organ failure.

“Emergency medical service is delivered along three operational pathways: coverage of highways and roads, mostly in collaborative partnership with the Federal Road Safety Corps; coverage of Emergency within States and FCT, working in collaboration with respective authorities and involving domestic, workplace-related, assault and sports incidents.

“Finally the rural ambulance service, in collaboration with local government, ward and primary healthcare centres, to meet rural community emergency needs around access to maternal and child health, especially at odd hours,” he explained.

Ehanire further reiterated the importance of NEMSAS program as the missing Link that strengthens the National Health System by filling the gaps of poor physical and financial access to healthcare at times of dire need and distress and coordinating referral services to move patients from one treatment tier to another by Ambulance in emergency situations.

He added that EMTC functions through a multi-sectoral stakeholder partnership to ensure the service eventually becomes available to every Nigerian, regardless of where they live.

“Ensuring access to timely emergency care is critical to meeting WHO’s commitment in its 2019–2023 General programme of work, “to serve in particular the most disadvantaged, marginalized hard-to-reach populations, including those affected by emergencies, to ensure that no one is left behind,” he added.

He noted that the program was part of the continuous effort of the FMOH to respond to unmet needs in life-threatening medical emergencies, from injury and illness across the human life course, regardless of gender, age group or circumstance, and deliver prompt care on-site.

Amongst others he said transportation to accredited centres, to enter the health system for definitive care; all without financial conditions imposed on the patient within the first 48 hours.

The minister noted that service given this way removes barriers and saves lives in a highly time-dependent emergency, as part of the Basic Minimum Package of Healthcare Services and Emergency Medical Treatment promised in the 2014 National Health Act.

According to him, This project is no doubt ambitious and has been met with skepticism by some persons, because of its novelty and a perceived lack of good track record in Africa to run such complex partnerships, on which the operations is to depend.

“But this program is also q very promising and much overdue initiative that could finally begin to address the high rate of maternal Under-5 child and accident mortalities, that has been stagnant in Nigeria in the last few years, despite substantial government and Partner investments to reduce them,” he added.

Ehanire said that the NEMSAS program can solve issues of lives lost due to lack of first aid and transport from home or accident scene to treatment, or lives lost to denial of treatment due to inability to pay.

“As the concept allows dedication of most of the resource to the actual purchase of service, value for money is enhanced.

“This ceremony is to sign the MOU; it is not a program Rollout, which will be in the FCT in a matter of weeks. We also introduce the partners, partnership and concept of Emergency Medical care. Using lessons learnt from the FCT delivery model, the Rollout will follow in State by State with functional 112 toll-free Emergency Call facility, till all States are integrated to the network,” he explained.

He, however, stressed that Nigeria was striving, like other countries, to rebuild its economy in the wake of the COVID-19 pandemic and to construct new infrastructure to address existing gaps.

“The entire emergency medical service relies on a functional facility network of primary and secondary health centres.

“The partnership with private care providers is indispensable in bridging what would be gaps in an infrastructure network. Beyond supporting citizen health, this program will create jobs and improve quality of life and stabilize society.”

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