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Investigation:Poor Abuse , Communication,Others Bedevil Kwara Health Insurance Scheme

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Kwara Health Insurance Scheme

 

In 2020, the Kwara State Government, launched the Kwara Health Insurance Scheme (KHIS) to make access to basic healthcare by Kwara indigents seamless. The program however hasn’t been entirely flawless. In this report, Omolola Afolabi unravels some of the inadequacies bedeviling the scheme in the state.

For Sanni Amuda, a 46-year-old artisan in Awodi Gambari, Ilorin, the past few years have been akin to sprinting through the fog. His income has been irregular whilst also struggling with meeting his family’s needs.

He recalls a watershed moment when the government announced the commencement of the Kwara State Health Insurance Scheme (KHIS). He said he felt he could save funds and take care of his wife and four children’s medical needs by subscribing to the scheme but he soon met a brick wall of challenges.

“I was so excited about the scheme as I thought it would make access to quality healthcare for my family and I easy and affordable. I went with my wife and four children and after a long, stressful day of queuing up to register, we eventually got all our names and passport photographs captured. They promised to call me soon to pick up our cards but till this moment, they have not communicated that to me.”

Sanni Audu

Sanni Audu

Amuda who works as a carpenter has seen his enthusiasm give way to disbelief. He says the scheme is a scam. He was vehement.

The scheme allows for a maximum number of six persons to enroll from each family but it’s been six months since Amuda registered his family without any official proof.

A scheme blighted with challenges

The Kwara State Health Insurance Scheme was established by law in November 2017 to provide mandatory health insurance coverage to all residents of Kwara State, particularly the indigent people amongst its burgeoning population of 3.2 million people.

The insurance package provides coverage for consultations, diagnostic tests, and medication for all disease categories, including hypertension and diabetes, that can be managed at a primary health care level and limited coverage of secondary care services.

Secondary care services provided include radiological and more complex laboratory diagnostic tests and hospital admissions for different disease categories, minor and intermediate surgery, antenatal care and delivery care, neonatal care, immunizations, annual check-ups and HIV/AIDS treatment care support.

Excluded from the program are high technology investigations (computed tomography and magnetic resonance imaging), major surgeries and complex eye surgeries, family planning commodities, treatment for substance abuse/addiction, and cancer care requiring chemotherapy.

According to Governor Abdulrahman Abdulrazak in 2021, about 30,000 people have registered under the scheme with only 5 per cent benefiting from the scheme. The scheme, according to Kwara indigents and residents who spoke with Solacebase has been fraught with several problems right from its inception. The inadequacies are seen in the poor rate of adoption and utilization of the scheme by the people.

Amuda added that despite being an indigent in Kwara, he still spends a significant part of his meagre earnings on healthcare for his family. The scheme, touted by the Abdulrazak-led administration in different quarters as a novel initiative, has become a shadow of its projected promises.

A Kwara indigene, Falilat Ajoke, said she had enrolled for the scheme 3 months ago and has been left in the dark with no response to her enquiries.

“I have had some health challenges for a while now and it would have been better managed if I was able to get information from the designated quarters. Because of my state of pregnancy, I looked forward to accessing the services but when their contact number was not reachable, my only resort was to consult traditional and private facilities.”

Faliat Ajoke

Faliat Ajoke

Mrs Falilat Ajoke has dialed the number designated for calls severally by the KHIS without any response .

Ajoke reiterated that the contact numbers of the scheme were not reachable when she and her friends attempted to reach the agency for enquiries without success. Attempts by Solacebase to reach KHIS via its contact numbers on 08148831004, 09024770622 were futile. Calls placed to the numbers didn’t connect.

The Scheme doesn’t profit us: The private sector

Sitting on a sprawling chair in a private hospital in the centre of Ilorin, a young medical officer, Sekina Jimoh wears a defiant countenance. Dressed in a floral chiffon blouse with a pen in her hands, Jimoh was drafting a prescription during this reporter’s visit.

According to her, the hospital has been running at a loss since the commencement of the scheme. She explained that:

“Challenges on our part are more of finances because of the capitation which is still not sufficient for the type of treatment we offer. There are a lot of old patients with hypertension and diabetes and other illnesses that patronize us every 10 days or two weeks and sometimes we have to run tests and dispense the required medications without charging them.”

Capitation is the payments agreed upon by a health insurance company and a medical service provider. They are fixed, pre-arranged monthly payments received by a physician, clinic, or hospital per patient enrolled in a health plan, or per capita.

According to the medical officer, the hospital ensures the capitation on every of their patient is judiciously expended and when it is exhausted, we ensure the treatment is completed or it gets to a safe stage before a referral, in case a need for that arises.

She explained that Kwara State wouldn’t reimburse for vital extra services rendered by the medical facility to members of the scheme. The capitation given is not enough, she stressed.

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Asked how the hospital makes up for this loss, she said, “As per humanitarian service, well we can’t deny the patient his or her drugs. It will eventually be a burden on the hospital when the registered patient develops complications. So we attend to them and make up for it in other places when the possibility comes.”

She explained that primary and secondary treatments, primary and maternal care, child care, and malaria are the treatments her hospital offer. She, however, clarified that this is a general problem and that private hospitals are not discriminated against by the state government.

About the hospital’s referral policy under the scheme, she said: “We only refer patients when it is absolutely necessary. To do that, we reach out to the Kwara Health Insurance Agency with the patient’s details to release a code.”

“The “genuinely poor” are cheated out of the system”

Partnering with the Islamic Development Bank and a group of non-profit organizations dedicated to improving access to quality healthcare in Africa, PharmAccess, Kwara Health Insurance Scheme (KHIS) was designed to improve access to medical care by rural, and low-income communities who often struggle with high out-of-pocket expenses when seeking healthcare.

Touted as a unique initiative, government officials often claim this objective has not been derailed since the launch of the project. However, findings by Solacebase proved otherwise as high-income earners are gaming the system, thereby reducing the chances of poor people benefiting from the scheme.

The nurse and Officer-in-charge of Zango Ward Clinic and Maternity, Ilorin East Local Government Area (LGA) who simply identified herself as Khadijah recalls an incident when a wealthy car dealer came with his large family and several other employees to register as indigents.

“He would not agree to register otherwise and officials were left with no choice than to capture them as such,” she said.

Another nurse, Muslimah Adetoun lamented that wealthy indigenes come under the guise of not being able to afford the paid scheme. This invariably limits the chances of those who are genuinely poor.

She added that several registered members of the scheme have stopped patronizing hospitals due to  lack of confidence and poor access to the scheme adding that many people do not have official proof of enrollment. She lamented that many residents who enrolled have relocated from the communities where they initially registered and find it difficult to transfer their subscription to another clinic.

 

 

 

She explained that communicating with KHIS office is often challenging which makes giving them feedback discouraging.

“We tried to create a feedback channel so we can communicate some of the issues we encounter but that has been neglected as we are never able to reach them”

Kulende Primary Health Centre, Ilorin Eaast LGA, looks

deserted with old and rustic-looking equipment. Mariam Abdulkareem, a nurse, heads the PHC. Although she acknowledged that her PHC has 201 enrollees, a great number of people who require the service offered by the scheme are yet to benefit.

“There is a service offered by the scheme for civil servants but they haven’t added maternity fee for now. Up to 50 per cent of the capitation is given to the health centre and an extra is added during emergencies.”

“Some have registered and for long their names are yet to be officially captured and sent to the health centre. They have come up to complain several times about it, but I always tell them I’m not the one in charge so they always have to go home gloomy,” she lamented.

Primary Health Care is dead in Kwara, expert

Dr. Adekunle Salau is a medical professional who has been working in Kwara State for over ten years. He said the state is poor and struggles to pay the national minimum wage adding that poor remuneration eventually affects the health-seeking behaviour of the people.

“When the standard of living of a people is low, they won’t have a lot to spend on health and medical emergencies. Therefore, health insurance is supposed to step in to take care of that. Even the ones that are not emergencies, health insurance should be able to cover for it,” Salau said.

However, Salau opined that the availability of a health insurance scheme is not as important as the availability of quality health facilities to deliver the provisions of the scheme.

“If people are enrolled in the health insurance and are not able to access good healthcare, the purpose is defeated. They move away from PHCs to the general hospitals. The general hospitals are doing well but the issue is that they have a very high patient load and they are seriously understaffed. This, therefore, discourages a lot of people from visiting the general hospitals,” he added.

“But when the hospital close to you, can’t give you what you want then you would have no choice but to look elsewhere.”

He explained that it is difficult for people to fully benefit from the insurance scheme if there are no commensurate healthcare services, especially at the primary healthcare level which is usually the closest to them.

 

He stressed that PHCs are as good as dead in Kwara state. “Our PHCs are understaffed. It is one of the factors limiting people’s access to healthcare and rather fuels the bad habit of health seekers who rely on self-medication, patent medicine sellers and quacks.”

On efforts needed to create a linkage between health insurance and access to quality healthcare at PHC level, Salau said there is more work to be done as current realities don’t augur well for the country, predominantly the rural populace.

He explained that PHCs should be able to manage diseases such as malaria, and tuberculosis. But with the unavailability of drugs and necessary equipment, patients readily turn to alternative care.

“I understand it’s not the job of the insurance agencies to equip and staff health facilities but when these facilities don’t have the necessary working tools, the goal of the insurance scheme will be defeated. Equipping healthcare facilities should be where the real insurance should start from because that is where people who live in rural areas first turn to.”

The KHIS refused to comment on the issue. Initial multiple attempts to reach the executive director, KHIS, Dr Olubunmi Jetawo-Winter had proved abortive.

Later in a separate phone conversation with this reporter, Jetawo-Winter, promised to respond to the questions and asked that the email be resent.  When the questions were sent to her, Jetawo-Winter became evasive requesting the reporter to resend the email using an official email address. As of the time of filing this report, she still hasn’t replied the questions posed to her. Some of the questions contained in the email sent to her bothered on equitable utilization of the scheme, poor communication and feedback channel between the agency and other stakeholders amongst others.

Meanwhile, on May 27, the information desk of KHIS eventually replied to emails asking for comments. The desk promised to grant an interview with Solacebase on the issue soon.  As at the time of filing this report, the agency is yet to get back to this newspaper despite repeated reminders.

Efforts to reach out to the Country Directors of PharmAccess Foundation, Mrs Njide Ndili, and Regional Head, Islamic Development Bank, Mayaro were also unsuccessful. They are yet to respond to calls, emails and text messages sent to them at the time of filing this report.

This publication is produced with support from the Wole Soyinka Centre for Investigative Journalism (WSCIJ) under the Collaborative Media Engagement for Development, Inclusion and Accountability project (CMEDIA) funded by the MacArthur Foundation.

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Rano’s Peaceful Legacy: More Than a Slogan, One Tragedy Won’t Define Us

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For decades, Rano Garin Autan Bawo has proudly stood as a symbol of peace and harmony in Kano State. It is a place where neighbors look out for one another, where disputes are settled through dialogue, and where diversity is met with respect—not resentment. In Rano, peace is not just a slogan—it is a way of life passed down through generations.

The tragic incident that recently occurred at the Divisional Police Station in Rano Local Government has deeply shaken our community. Known for generations as one of the most peaceful and united areas in Nigeria, Rano now faces the painful reality of an attack that led to the death of a Divisional Police Officer and the destruction of police property. This senseless act of violence goes against everything our community stands for and must not be seen as a reflection of who we are.

Rano has long been recognized for its peaceful spirit, tolerance, and respect for all. People from different backgrounds, religions, and cultures have lived side by side here in harmony. This didn’t happen by chance—it is the result of years of effort by our leaders, religious figures, and ordinary citizens who believe that our strength lies in our unity and diversity.

Our respect for law and order is deep-rooted. We understand the crucial role that security personnel play in keeping our community safe. The people of Rano have always appreciated the risks and sacrifices made by the police, military, and other agencies to protect lives and property.

Respect for the law here is not just about obeying rules—it’s about a shared belief in justice, fairness, and solving problems peacefully and legally. This belief has helped build a respectful and cooperative relationship between the police and the people.

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What happened at the police station is completely out of character for our community. The individuals who carried out this attack do not represent us. Their actions go against the values that have shaped Rano. We strongly condemn what they did and make it clear that their behavior does not reflect who we are.

The loss of the Divisional Police Officer is not just a blow to the Nigeria Police Force or the Kano State Police Command—it is a loss for all of us. He wasn’t just doing his job; he was part of our extended family. His death is an attack on the peace and security that we all hold dear.

We send our deepest condolences to his family. No words can ease the pain of losing a loved one in such a brutal way. Our thoughts are also with his colleagues in the police force, who have lost a brother and a friend.

We also stand with the Kano State Police Command and the Nigeria Police Force as they face this heartbreaking loss. We understand how much this affects their morale, especially at a time when their work is more important than ever.

Destroying police buildings and equipment is not just an attack on law enforcement—it’s an attack on the very system that helps keep us safe. These facilities belong to the people and serve the entire community. Damaging them harms everyone, especially the most vulnerable among us.

We urge the government and relevant authorities to investigate this incident fully and fairly. Those responsible must be held accountable. Justice must be swift and uncompromised. Our community deserves to see the law upheld and the wrongdoers brought to book.

To our young people—the future of Rano—we ask for calm and reflection. We know that you may be frustrated or angry about many issues. But violence is never the answer. Taking the law into your own hands only brings more pain and setbacks for everyone.

Instead, we encourage our youth to focus on positive, constructive paths. There are peaceful, legal ways to raise your voices and push for change. Use those channels. Help move our community forward.

Rano must now focus on healing, rebuilding trust, and recommitting to the peaceful values that have always defined us. We must come together—young and old, leaders and citizens—to ensure that such violence never happens again.

We call on traditional leaders, religious figures, community elders, youth leaders, and all residents to stand united in promoting peace and respect for the law. Let’s strengthen our partnership with security agencies and support their efforts to keep us safe, while also holding them accountable to serve with respect and dignity.

How we respond to this tragedy will shape our future. Let us choose unity over division, peace over violence, and hope over despair. The actions of a few will not define us. We will protect the legacy of peace that Rano is known for and continue working together for a better tomorrow.

Buhari Abba wrote this piece from Unguwar Liman Rano.

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My Mother, My North Star: How Women’s Empowerment Can Transform the North

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Ahmad Muhammad Ahmad

I was recently listening to Sarki Sanusi’s excellent presentation titled “How to Stop Manufacturing Poverty,” where he remarked that the single silver bullet that could solve 70% of our problems in Africa would be the education of the girl child. This inspired this write-up. If you find this too long, you can skip to the last three paragraphs for my overall message.

If you’ve been following me for a while, you might have come across my mother’s story time and again. I will share it once more because it is a quintessential example of Sarki Sanusi’s assertion.

But before I go there, allow me to digress a bit to share another example of a mother being a role model and inspiring a generation. I used to think it was a coincidence, but it seems too perfect to be random that the same woman—Hajiya Mariya Sanusi Dantata—produced Aliko Dangote, Sayyu Dantata, and Sani Gote: three billionaires and established businessmen. At the very least, she must have given them the latitude to pursue excellence. Being the daughter of a wealthy man and a businesswoman herself, she likely had a clear vision of what excellence looked like—and instilled that in their upbringing.

She may not be literate, but she is certainly aware. From my few encounters with her, I found her to be smart, curious, and disciplined. She must have passed these traits on to her children, giving them a sense of purpose and drive.

Similarly, I remember listening to Abba Karfe (founder and chairman of the renowned Garba Karfe Investments, with interests spanning manufacturing and retail) and Sammani Adamu (chairman of El-Samad, a textile conglomerate) reflect on the roles their mothers played in their entrepreneurial journeys. Although they spoke at different times and on different topics, they both acknowledged how much their mothers encouraged their business pursuits.

On my end, I have also always seen my mother as another perfect example of the ripple effect of women’s empowerment. She raised six of us (one of whom is now late) all by herself. Circumstances led to her being married for only 13 of her 69 years. Her first marriage lasted nearly 11 years before she became a widow with five children. Her second marriage lasted only three years. So, at 23, she was an unemployed widow with no formal education, saddled with the responsibility of raising five children—three of whom were girls.

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For the next 11 years, she would reinvent her life: learning how to read and write (through the then Agency for Mass Education), obtaining a university degree, and eventually securing a job. It was only then that she considered marriage again. But as fate would have it, it didn’t work out—though she left that marriage with the gift of one more child, the sixth and last. She has remained unmarried for the past 36 years, never glorifying singleness, but instead dedicating her life to building a career in civil service, raising her family, and engaging in genuine community service. Today, she sits on the board of one of the government agencies—nine years after her retirement.

Recently, during a conversation, she shared a reality I had always witnessed but never heard her express. For the first time, she said that the life she chose meant she had to forgo the comfort of being cared for by a man. In fact, she has very little memory of such care, save for her brother who had been a pillar but who passed away too early. She had to be both the man and the woman, living life without waiting for help or rescue. Occasionally, support would come, but it was never reliable. She told me there is no glory in widowhood or singlehood, but if life throws that at you, you can still build something remarkable.

Many times, I tell people that I find more inspiration in my mother’s life than in my father’s—even though the scale of his influence and impact is broader. From him, I learned honour, authority, and discipline. But from her, I learned courage, resilience, and audacious hope. Life set her up for failure, but she resisted. And what makes it even more remarkable is that she did it as a woman, with very little support.

As Sarki Sanusi mentioned, the future of our progress and development lies in the empowerment of women. Every single good you see in me comes from my mother. I take very little credit. I usually say I don’t have a story yet. I hope to build a remarkable life, but I use her light—the remarkable life she built for herself and for me—to shine. And that will continue until I’m able to build something equally remarkable.

Quite recently, I was listening to Naval Ravikant—the famous entrepreneur and investor—share his childhood experience. He said he initially aspired to be a scientist, specifically an astrophysicist. But his mother, observing his personality, told him she believed he would become a businessman. She noticed how he would critique businesses and their service processes. She had already seen a curious business mind in him. That insight planted the seed that grew into Naval the thinker, investor, and billionaire.

So, back to the topic: if we can instill enough ambition in women, it will filter down to their offspring—both male and female. This creates a community of ambitious individuals whose lives are rooted in excellence and determination, like the examples shared above. Had my mother not found a higher purpose in education and work, I might have become the sixth of 8–10 children she could have given birth to, making it more challenging to ration the little resources available and provide proper childcare.

Empowering women begins with educating them—formally or informally (especially for older women in underserved areas)—and giving them the latitude to live a dignified life. The bottom line is for a woman or girl to become aware—of herself, her environment, and the opportunities around her—and to aspire toward something meaningful. An unaware and unambitious woman is highly likely to pass that mindset on to her children or become a burden herself.

These stories are too perfect to be a coincidence. They represent a pattern and a model that can be replicated at scale: empower as many women as possible to live a dignified life, and they will empower the next generation.

 

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As Barau, Kano State Government Compete in Offering Scholarships, Can Barau Unseat Kwankwasiyya in 2027?

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By Senior Political Editor Abbas Yushau Yusuf

Senator Barau I. Jibrin, the Deputy Senate President, has been in the headlines since assuming office, proposing initiatives and policies that will win over his senatorial area, Kano North and the state at large. Despite the Kwankwasiyya Tsunami that swept the 2023 polls in Kano, Senator Barau Jibrin scaled through and won his election. Can this be attributed to past projects he completed for his constituency?
keen political observers understand that after emerging as the Deputy Senate President, Senator Barau Jibrin has come up with another strategy which was employed by the Kwankwasiyya political movement when it clinched power in the 2011 general elections in Kano which is offering foreign scholarships to the sons and daughters of the less privileged in the state.
Below is the breakdown of the recent scholarships offered by Senator Barau Jibrin to Kano indigenes as released by his Special Adviser on Media and Publicity, Ismail Mudaahir.
“One week after sponsoring 70 students for postgraduate scholarships abroad, the Deputy President of the Senate, Senator Barau I. Jibrin, is set to offer scholarships to 300 students to pursue master’s degrees in Nigerian universities.” the statement reads
“Through the Barau I. Jibrin Foundation (BIJF), 70 students selected from across the three senatorial districts of Kano State departed the country via Malam Aminu Kano International Airport (MAKIA) for India on December 29th, 2024.”
In addition, the Deputy President of the Senate, who is also the First Deputy Speaker of the ECOWAS Parliament, announced that 300 students will benefit from his domestic postgraduate scholarship program this year.
To this effect, the foundation opened applications for “postgraduate domestic scholarships for the 2025/2026 academic session.”
“The foundation, dedicated to fostering academic excellence and providing educational opportunities to deserving Kano State graduates, aims to support 300 outstanding graduates from recognized universities in pursuing their postgraduate studies at selected universities across the country”.
Secretary of the Postgraduate Scholarship Committee of the BIJF, Maikudi Lawan, PhD, said the program offers a unique opportunity for academic growth, research, and human capital development in various fields of science and technology, which will empower the country’s next generation.
He said the programs include: M.Sc. Artificial Intelligence, M.Sc. Robotics Technology, M.Sc. Cyber Security, M.Sc. Data Science, M.Sc. Information Technology, M.Sc. Software Development, M.Sc. Mineral Exploration, M.Sc. Hydrogeology & Environmental Geology, M.Sc. Oil and Gas Operations, M.Sc. Applied Geophysics, M.Sc. Metallurgical and Material Engineering, M.Sc. Climate Change Management, M.Eng. Mechatronic and M.Eng. Intelligence System.
He added that six universities, Bayero University Kano, Ahmadu Bello University, Zaria, University of Ibadan, University of Lagos, Obafemi Awolowo University, Ile-Ife, and University of Nigeria Nsukka, have been selected for the program.
Every political observer in Kano can attest to the success of Kwankwasiyya movement’s politics of offering scholarships to the sons and daughters of the less privileged. For example, when the NNPP national leader, Engineer Rabiu Musa Kwankwaso, bounced back as Governor for the second term in 2011, he came up with foreign scholarships for Kano indigenes who had a minimum of second-class upper degrees. when such laudable project was announced many people then didn’t believe it was going to happen.
The Kwankwasiyya Government sequentially sponsored 501, 502, and 503 set of students on foreign scholarships sent abroad on different batches to study in different fields. This set of people sponsored by Engineer Rabiu Musa Kwankwaso’s administration traversed many parts of the world, including India, Cyprus, Egypt, Turkey, Jordan, and other parts of the world.
By the time Governor Kwankwaso finished his second term in 2015, most of the students sponsored had already returned from their studies. Many analysts believed that this life changing opportunities offered by his administration was one of the reasons for the unconditional loyalty of many of the beneficiaries and their families to the Kwankwasiyya movement.
This among other things was one of the reasons that gave Dr. Abdullahi Umar Ganduje an easy ride leading him to win the 2015 governorship election with a landslide. however, the relationship between Dr. Abdullahi Umar Ganduje and his former boss and political ally deteriorated over time and currently do not see eye to eye due to political differences.
In 2019, the Kwankwasiyya Governorship candidate, Engineer Abba Kabir Yusuf, won the Governorship election in the first round by defeating incumbent Dr. Ganduje, whom they accused of abandoning their programs in which he was the grand Deputy commander of the Kwankwasiyya movement in 2015. it is becoming apparent that Engr. Abba Kabir Yusuf who is the current governor of the state will continue the legacies laid by the leader of the movement including the sponsoring of students on foreign scholarships.
A lot of people are of the opinion that the current strategy employed by Senator Barau I. Jibrin in offering scholarships to the indigenes of Kano, including the less privileged, is a sign that the Deputy Senate President is eyeing the Kano Governorship seat in the 2027 general elections. Will this be a plot to dislodge the Kwankwasiyya Government under the NNPP led by Governor Abba Kabir Yusuf in the coming elections?

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