By Staff Reporter
Information has emerged that NHIMA has been riddled with complaints of tribalism and questionable accreditation of health facilities for UPND aligned individuals.
Information availed to Daily Revelation points to irregularities ranging from abuse of authority, naked tribalism, as well as regional appointments.
All the initiators of NHIMA (people behind the establishment of NHIMA) were fired when UPND formed government except for one person . Former Director General (DG) James Kapesa, Dr Mpuma Kamanga (former director quality assurance and accreditation), Tontera Siwale (former director health insurance services) were all gotten rid of and only Herryman Moono was left.
The reasons for getting rid of all the directors, until now have not been substantiated.The other people who are still there among initiators of the scheme is the ZSIC project team. It was revealed that the reasons for not firing the directors from the ZSIC project team was because the board and management failed to “manufacture” cases to use as pretext for their dismissal.
However, it is believed that cases are now in the offing that will be used to either relocate them or get rid of them entirely because, according to the information gathered, the board and management are alleged to have their own people to take over the positions.It is further revealed that the accreditation committee which usually comprises Zambians from different ethnic groups and professional backgrounds was dissolved and replaced by people from one region: Chimunya Miyanda (internal auditor), Herryman Moono (director research), and Perpetual Halwindi (Claims manager).
This committee is in charge of reviewing and vetting accreditation applications from health facilities, assess healthcare providers and provide reports to the board vis-à-vis accreditation with NHIMA. Before its dissolution, this committee comprised medical professionals with the capacity to independently oversee assessment process.Impeccable sources told Daily Revelation that there were serious vested personal interests being advanced by members of the board and management.
Management is allegedly pushing agendas outside the jurisdiction of the NHIMA.Information gathered revealed that this December, 2023, some members of the board and management travelled to China to source for suppliers including CT scans and MRI machines and other medical equipment – a responsibility outside the mandate of the NHIMA as per Act No. 2 of 2018.
NHIMA’s responsibility is to drive the overall universal health coverage through supplementary funding by paying claims for members who access accredited facilities, and not to purchase medical equipment. Purchase of medical equipment is a responsibility of the ministry of health, while purchasing of drugs is a mandate given to Zambia Medicines and Medical Supplies Agency (ZAMSA).
Sources also revealed that NHIMA’s financial pool is drastically declining, thus threatening the Scheme’s sustainability and existence. Currently NHIMA’s pay-out is more than what the Scheme is able to generate, thereby risking the sustainability of the facility.
According to sources, the deficit is being covered by investments and savings that were made during the time of the former director general James Kapesa.
Information gathered shows that Kapesa was a disciplined person who many times refused to even go to meetings outside the country because he refused to be extravagant.
He is said to be unlike the current team who are alleged to be global trotting while the Fund is bleeding, with information indicating that Kapesa at one point returned to the ministry of health over US $10,000 given to him to go to the UN General Assembly in Geneva.
“All this was to ensure NHIMA served the purpose for which it was established,” sources said.
Investigations revealed that as the ZISC project comes to a close, the NHIMA board and management are determined to ensure all directorate positions are occupied by people from some regions in order to consolidate the hold on power and continue with the capture of the Scheme.
“There is heavy boasting in the corridors that we are now running the show,” sources said.
Efforts to contact NHIMA director general Michael Njapau and the board chairperson Dr Richard Mwiinga failed as they were both said to be out of the country.The government of Zambia established the National Health Insurance Authority (NHIMA) pursuant to section 4 of the National Health Insurance Act No.2 of 2018. The Scheme sought to provide a sound and reliable healthcare financing for all Zambians regardless of socioeconomic background.
The functions of NHIMA included, implementation and operationalization of the National Health Insurance Scheme, management of the National Health Insurance Fund, accredit to the NHIMA healthcare providers such as pharmacies, clinics, and hospitals, and development of a comprehensive benefit packages to be accessed by the members.
However, since the UPD government came into power, a lot of changes have been made to the Scheme which have potentially undermined and compromised NHIMA operations. Zambians have been complaining about the way NHIMA is being run under the UPND administration. This newspaper has been receiving many complaints from the general public over alleged abuse of funds.
