ECWA Health Development and Delivery Support Initiative (EHDDSI)
Introduction
The vision for the establishment of the ECWA Health Insurance Scheme (EHIS), now implemented through the ECWA Health Development and Delivery Support Initiative (EHDDSI), emerged from the growing need to sustain quality healthcare delivery within the Evangelical Church Winning All (ECWA). Historically, ECWA had established numerous healthcare facilities across Nigeria to provide affordable and quality medical services to its members and surrounding communities. These facilities became widely recognized under the respected “ECWA Health Brand.”
However, over time, increasing population growth, rising healthcare costs, and the inadequacy of outof-pocket (OOP) healthcare financing created significant challenges for ECWA health institutions. Many healthcare facilities struggled to maintain quality services, meet personnel obligations, and sustain operations. Some facilities became moribund, while others were shut down entirely. In addition, ECWA staff increasingly depended on financial assistance from the Church to settle medical bills, as the existing medical allowance system could no longer cope with the rising cost of healthcare services.
Birth and implementation.
Recognizing the urgent need for a sustainable healthcare financing mechanism, the ECWA Executive (EE) in October 2017 constituted a Committee to develop a viable alternative to the obsolete out-ofpocket payment system. The Committee proposed the establishment of two complementary institutions: the ECWA Health Insurance Scheme (EHIS) and an ECWA Health Maintenance Organisation (HMO). These proposals were presented to the ECWA General Church Council (GCC) in April 2018, where they received overwhelming approval. The GCC resolved that both institutions should operate independently while complementing one another in strengthening healthcare financing and revitalizing the ECWA Health Brand.
The same General Church Council session elected Rev. (Dr.) Stephen Panya Baba as ECWA President. Upon assumption of office, he demonstrated strong commitment toward the implementation of the healthcare financing vision. Consequently, the ECWA Health Insurance Scheme Implementation Committee (EHIIC) was inaugurated in June 2018 to drive the realization of the Scheme. The Committee worked diligently with the support of the ECWA Executive and submitted its implementation progress report in April 2020.
In furtherance of the vision, the ECWA Executive constituted the pioneer Board of Directors for the ECWA Health Insurance Scheme in June 2020 under the chairmanship of Professor Tanimola Akande. Other members of the Board included:
- Joab Bonat Tagwai,
- Chinoso Emenike,
- Joy Shuaibu,
- Ruth Dul,
- The ECWA Director of Medical Services – (Dr. Samaila Maikah)
- The ECWA Finance Director – (Mr. Friday Mamman)
- The Managing Director/CEO of ECWA Portfolio Management Limited – (Mr. Moses Kolawole).
With financial support through a grant from the ECWA Executive, the ECWA Health Insurance Scheme officially commenced administrative operations on 16th November 2020 under the name “ECWA Health Insurance Scheme – EHIS.” The office began with five staff members and a Consultant. Mr. Shamee Samuel Vershima served as the pioneer Acting Administrator, while Dr. Moses Esuga served as the pioneer Consultant. Other staff members were:
- Ofon Brownson Ikpe – Accountant
- David Bari – Information and Communication (ICT) Officer
- Sarah Bako – Administrative Assistant I
- Gloria Jerry – Administrative Assistant II
- Rebecca Christopher – Cleaner
The team immediately embarked on sensitization and advocacy visits to ECWA formations across
Nigeria while simultaneously training healthcare facility personnel on the operational processes of the Scheme.
The Scheme operated under two basic sectors (the formal and informal sectors) and developed three formal sector healthcare plans consisting of defined premium structures and corresponding Healthcare Benefit Packages (HCBPs). These plans were presented to the General Church Council (GCC) in 2021 and subsequently approved with minor modifications. The GCC further approved that premium contributions should commence in July 2021, while healthcare service delivery under the Scheme would officially begin on 1st October 2021.
Healthcare delivery formally commenced on 1st October 2021 with a network of 68 healthcare facilities, of which 34 were active at inception. The Scheme also started operations with 47 contributing organizations, covering 2,288 active principal enrollees and a total enrollee population of 3,612, including dependents.
As part of its institutional development and legal formalization, the Scheme was registered with the Nigerian Corporate Affairs Commission in October 2022 as the ECWA Health Development and Delivery Support Initiative (EHDDSI) as the corporate name, operating as an Incorporated Trustees/NonGovernmental Organisation. EHDDSI thereafter became the corporate entity responsible for implementing the programmes and operations of the ECWA Health Insurance Scheme.
Growth
Since the commencement of healthcare service delivery, EHDDSI has experienced remarkable growth and expansion. Between 2021 and 2026, the number of healthcare facilities increased from 68 to 105, while active facilities rose from 34 to 75, representing a 54% increase in total facilities and a 123% increase in active facilities. Similarly, the number of contributing organizations expanded from 47 to 96.
Enrollment under the Scheme also witnessed tremendous growth. Active principal enrollees increased from 2,288 at inception to 18,612 by 2026, while the total active enrollee population, including dependents, rose from 3,612 to 21,522. This represents approximately 713.5% growth in principal enrollees and 496% growth in total enrollee coverage.
In addition to enrolment growth, EHDDSI has distinguished itself through innovation and prudent resource management. The Scheme successfully digitalized its operations through the development of an integrated website and portal system for enrolment, treatment authorization, claims processing, vetting, approvals, and payments, all coordinated electronically through internet-based platforms. The Scheme also developed a highly competitive healthcare tariff system and effectively coordinated operations across multiple states in Nigeria with a lean workforce.
Today, EHDDSI stands as a rapidly growing healthcare support initiative committed to expanding access to affordable and quality healthcare services through strategic partnerships with healthcare facilities, organizations, and stakeholders. The organization continues to strengthen healthcare delivery systems, improve the welfare of ECWA workers and communities, and sustain the vision of accessible and affordable healthcare for all.
Impact
The impact of the Scheme has also been acknowledged by ECWA leadership. During the Thanksgiving Prayer marking the second anniversary of healthcare service delivery under the Scheme, Rev. (Dr.)
Stephen Panya Baba observed that requests for financial assistance toward huge medical bills from ECWA workers had drastically reduced since the establishment of the Scheme. This development underscores the significant socio-economic benefits and positive impact of EHDDSI on the Church and its workforce.
Through visionary leadership, strategic planning, institutional commitment, and prudent management, EHDDSI has continued to evolve into a sustainable healthcare financing and delivery platform dedicated to enhancing the health and well-being of individuals and communities across its operational coverage areas.