Tag: Aasandha

Visiting specialist doctors to improve healthcare services

The government is enlisting the services of visiting specialist doctors to improve healthcare services in the Maldives.

The ‘Super Specialist Service’ will employ neurologists, cardiologists, urologists, neurosurgeons, ENT doctos and pediatricians to provide consultations in different parts of the country.

The CEO of the national social protection agency, Mujthaba Jaleel, said twenty two foreign hospitals registered with the government’s health insurance scheme, Aasandha, have applied to send specialist doctors to the Maldives.

The visiting doctors will improve healthcare for people suffering from serious conditions, he said.

“Teams of Super Specialists have arrived today morning and have started work at the blood services unit and the Thalasseimia center. Some will start work at hospitals in the north and south tomorrow,” Mujthaba said.

President Abdulla Yameen inaugurated the Super Specialist service on Wednesday and handed over agreement copies to the overseas hospitals contributing to the super specialist program.

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Bangkok Hospital to provide Aasandha healthcare coverage

The Ministry of Health has held discussions with Bangkok Hospital to provide Aasandha, the Maldives universal healthcare scheme, in Thailand.

The ministry said today that discussions with Bangkok Hospital were held between heads of Bangkok Hospital and the acting Minister of Health Mohamed Nazim, reported local media Sun Online.

The discussions reportedly included providing specialist services and medical equipment to the Maldives, establishing a mechanism to prevent shortages of drugs, improving health clinic services in the Maldives, and ensuring the availability of certain drugs at Bangkok Hospital through Aasandha.

Earlier this year, President Abdulla Yameen inaugurated the ‘Unlimited Aasandha’ universal health scheme, as a part of his presidential campaign pledge and his first hundred day programme.

At the time, Yameen assured that the new unlimited service will be an upgrade from the existing Aasandha programme introduced by President Mohamed Nasheed which encountered a number of issues, particularly with regards to sustainability.

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Government to introduce chemotherapy, unlimited Aasandha and a doctor for every family in 100 days

Acting Minister of Health Abdulla Ameen has said President Abdulla Yameen’s administration will provide chemotherapy services, a doctor for every family, and will upgrade government’s health insurance scheme ‘Aasandha’ to provide unlimited services within the first 100 days of government.

Speaking at a press briefing held at the President’s Office late last week, Ameen pledged to improve the health sector. He said unlimited Aasandha services will bring an end to prescription drugs shortages and ease the process of obtaining medical care for chronic diseases.

“Unlimited Aasandha” was a key pledge of the Progressive Party of the Maldives.

Ameen said providing unlimited health care will not be a “burden” on the state budget or the client. Further details will be revealed at a later date, he added.

President Yameen has said the government’s economy is in a “deep pit” and vowed to cut state expenditure.

Ameen noted several Maldivians had moved abroad to obtain chemotherapy, as the service is currently not available in the Maldives and pledged to provide chemotherapy through the government’s health scheme Aasandha.

The government has also promised to provide cervical cancer screening services within 100 days.

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Government trials expansion of Aasandha to Maldivians in Sri Lanka, India

The government is this month expanding the Aasandha universal health insurance for Maldives nationals with resident visas in Sri Lanka and India to specific “empanelled” hospitals.

National Social Protection Agency (NSPA) Chair and State Minister State for Health Thoriq Ali Luthfee has said that to coincide with the Islamic Holy month of Ramadan, Maldives nationals residing in the two countries would now be covered for 397 surgical and medical procedures under the universal health scheme.

The coverage will be available at a set number of hospitals that have already been providing services under Aasandha in Sri Lanka and India.

The Aasandha universal health insurance program was introduced by former President Nasheed’s government in January 2012 and retained by President Waheed’s administration after the controversial transfer of power in February the same year.

The scheme, a public-private partnership with Allied Insurance, covers up to MVR100,000 (US$6500) in healthcare costs for Maldives nationals with valid national identity cards.

State Minister Luthfee claimed that the extension of the services to Maldivians residing in Sri Lanka and India was possible as a result of cutting systematic “waste” from the Aasandha system present from its inception under the previous government.

Healthcare challenge

The government has announced the launch of the new services at a time where health authorities have continued to come under criticism about limited health services being offered to patients domestically.

In June, President Waheed told staff at Indhira Gandhi Memorial Hospital (IGMH) in Male’ that his government was working to try and overcome “budgetary challenges” it has been facing in providing healthcare services.  The pledge was made amidst concerns about limited services at domestic health centres in the country.

Earlier the same month, the Ministry of Health had told Minivan News that insufficient salaries and concerns over staff safety were key issues driving “shortages” in the number of trained medical staff coming from abroad to work at hospitals in the Maldives, resulting in impacts to services.

However, despite economic difficulties facing the provision of health care in the Maldives at domestic hospitals and health centres, Luthfee said that Aasandha was funded and overseen by the NSPA under a separate budget budget to health finance – which was handled by the health Ministry.

He claimed that the outcome of extending Aasandha coverage for residents in Sri Lanka and India would need to be monitored to see if the system could be extended to for Maldivian expatriates in other parts of the world.

Monitoring

Luthfee claimed that one key consideration of the success of expanding Aasandha coverage would in whether Maldivians used the scheme “responsibly”.

Shortly after the launch of the scheme in January 2012, Health Minister Dr Ahmed Jamsheed – then Chief Operating Officer at Male’s ADK hospital – said the private health centre had been overwhelmed at the time by patients. He cited a 100 percent increase in demand for basic services in the first 14 days of the scheme.

Dr Jamsheed at the time contended that limited information on Aasandha’s financial structure was leading some members of the public to exaggerate their medical needs, with the mindset that all of their MVR100,000 allowance needed to be spent without regard for the system’s sustainability.

Luthfee claimed today that initial high pressure on the Aasandha system as a result of exaggerated medical needs had seemingly been tempered by greater accountability and a better understanding among the public of how the system was being financed.

“We have been able to balance this, partly through the use of a cost share agreement with private institutions participating in Aasandha,” he said.

Luthfee argued that the potential irresponsible use of universal medical care limiting services for the most in need was an issue initially seen in the early days of public healthcare systems all over the world – pointing to the early days of the UK’s National Health Service (NHS) model as one example.

He claimed that despite some of the challenges facing the system, Aasandha was now being operated in sustainable manner resulting from decreased costs to when the system was launched last year.  He claimed that despite the decreased costs, services offered through the scheme had not been compromised as a result.

Credit limits

Earlier this year, the Amrita Institute of Technology Hospital in Kochi, India, announced that it had been forced to impose a credit limit on services being offered to Maldivian nationals travelling for treatment under Aasandha.

As with other similar insurance schemes, the hospital at the time told Minivan News that it had been forced to control patient admittance as a result of over 7 million rupees (US$130,536) in unpaid charges.

Aasandha’s management said there had been some issues receiving money from the Finance Ministry to cover bills owed as a result of the insurance scheme last December – traditionally a “peak” period for Maldivians wishing to seek medical treatment abroad.

A spokesperson for the hospital could not be reached for comment today.

However, Cosmopolitan Hospital in Travandrum, India, one of several health centres “empanelled” under the Aasandha scheme, said it continued to offer medical services to Maldivian nationals under the programme.

The spokesperson added that he had not been made aware of any issues presently with payments or services being provided through the system.

Nawaloka Hospital, based in Colombo, Sri Lanka, which is also offers treatments under Aasandha, confirmed that it was not aware of any issues with payments being received for treatments and continued to provide medical services to Maldives nationals without any significant limitations.

Last July, the present government pledged that Aasandha would “not collapse”, despite the state owing four months of unpaid premium charges sought to cover medical treatments.

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Parents seek help after baby born with huge birthmark on face

The parents of a baby girl born with an usually large black birthmark across her face are seeking donations for surgery to remove the scar.

The baby’s parents are from the island of Meedhoo in Dhaalu Atoll in the Maldives.

The father of the baby said doctors had advised him to go abroad to seek further medical assistance as there was little they could do to help in the Maldives.

“Doctors advised me to go for a plastic surgery,” wrote Ahmed Shareef on Facebook, posting a picture of his newborn.

“But plastic surgery is not available here in Maldives. And it costs a huge amount. Please help me in anyway you can if it is possible. Even I will appreciate your good prayers too,” he adds.

The picture has gone viral across Maldivian social media since it was posted on Thursday, and has been shared by over 5000 users. The local community – both online and offline – are rallying to raise money to help the girl.

Speaking to Minivan News on Sunday, Shareef said he had been in touch with doctors from abroad who had given a preliminary diagnosis of Congenital Nevomelanocytic Nevus (CNN).

A nevus – the medical term for a birthmark – larger than 20 centimetres in diameter only occurs once in every half a million newborns. This is the first such case reported in Maldives, which has a population of around 350,000 people.

The scar went undetected during ultra sound scans throughout the pregnancy, Shareef explained.

Although the scar is believed to be benign, there is risk of it further spreading across the baby’s face and causing complications as serious as cancer, according to the family.

“There is a chance of the scar spreading. Or even it may become cancerous. So most of the doctors are saying go for surgery,” Shareef explained.

The young couple, who also have a four-year old son, say they are extremely worried about their daughter’s future.

“Just imagine how can a girl will live here with that. Think about her future,” he said. “The only way I can help my baby is to take her abroad, consult a specialist and do the surgery. But my wife and I cannot afford the travel and costs of the treatment. Please help me,” he begged.

Shareef is a primary school teacher while his wife is a clerk at the island council office, earning less than US$800 a month between them.

Shareef said his wife also had a heart condition requiring prescriptions and regular check ups.

“Despite all this, my wife is very strong. I am doing everything I can to help my wife and daughter,” Shareef said, thanking the public for its generous support so far.

While Shareef is struggling to raise money, little support is available from the state as the national health insurance scheme does not cover expenses for plastic surgery.

The Maldives has a culture of families and friends helping to raise funds for medical treatment to save loved ones, increasingly through social media.

Recently, a young woman launched a search for a Maldivian donor for her husband whose kidneys had both failed. She recently announced that two matching donors had been found.

Similarly, parents of a child born with cleft lip and palate ran a successful campaign called “Help Lisa Smile”. The family raised money through T-shirt sales, in addition to generous donations, and the operation was successful.

For more information on this story contact Ahmed Shareef on Facebook

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Health Trust Fund fundraising events raise over MVR 5.5 million (US$357,142)

Following a week of fundraising events the Health Ministry has raised over 5.5 million MVR (US$357,142) for the Health Trust Fund established in late April, falling short of the MVR 270 million (US$ 17,532,450) needed for health sector services.

The Health Trust Fund was established 20 November 2012 under Ministry of Finance and Treasury regulations and inaugurated on April 29, 2013.

The only way the Health Trust Fund can be maintained is through donations of sufficient assets and in this regard government and private sector contributions are very important, Minister of Health Dr Ahmed Jamsheed recently told local media.

He explained that the health sector requires an additional MVR 270 million (US$ 17,532,450), which requires public contributions and cooperation.

Previously health sector services were “covered by the people”, however following the start of the Aasandha universal health insurance scheme on 1 January 2012 the government of Maldives needed a “huge amount of finance” to cover expenses, said Jamsheed.

Therefore, the Health Ministry organised a series of fundraising events to “commence activities to raise funds, not to gather all the funds need to cover all health sector services,” he added.

“We want health services to be sustainable by putting an end to service disruptions due to machinery breakdowns as well as provide a systematic way for people to give in-kind donations,” Health Ministry Director and fundraising media team member Thasleema Usman told Minivan News yesterday (June 8).

“There has always been a budget shortfall at the Health Ministry, there has never been enough money,” Usman said.

“We wanted to try and do something for the Maldivian people, additionally there are also people who want to contribute [to the fund] for the benefit of the public,” she added.

Usman explained that the various fundraising events were organised as a start for the trust fund and to raise awareness among the public.

“We didn’t want this to be a ‘once off’ thing,” she said.

“Although the total amount of funds raised are still being tallied, as of this afternoon (June 9), the total reported was MVR 5.5 million (US$357,142), with over MVR 2 million (USD$129,870) in cash donations and more than MVR 3 million (US$194,805) from in kind contributions,” Maldives Food and Drug Authority (MFDA) Senior Scientific Officer and fundraising media team member Mariyam Shabeena told Minivan News today (June 9).

Budgetary needs

The health sector budgeted MVR 2.2 billion (US$142,857,000) for 2013, however around MVR 1.1 billion  US$71,428,500) or 50 percent of the total budget is allocated for the National Social Protection Agency (NSPA), according to Usman.

She said that over MVR 5 million is needed for social safety net subsidy programs, such as single parent’s allowance, foster parent’s allowance, disability registration and benefit and electricity subsidies, which fall under NSPA.

NSPA is also responsible for managing the national social health insurance scheme, a public-private partnership with Allied Insurance.

“Aasandha requires 1.13 billion MVR (US$73,376,550) to provide actual health care,” Usman said.

“An additional MVR 500 million (US$32,467,500) is required for Indira Gandhi Memorial Hospital (IGMH) operations and the Health Ministry budget also includes institutions, such as the Maldives Food and Drug Authority (MFDA), National Drug Agency (NDA), etc,” she continued.

Usman explained that the health trust fund will be transparent, with legal mechanisms to manage the money.

“The Health Ministry can only have a sustainable trust fund if funds are raised legally, by abiding with Finance Ministry regulations,” she said.

“The fund has a very well written policy that explains how the money will be used and what has been used,” Usman continued.

“A nine member committee chaired by the Health Minister will oversee the fund, which has a grading system to determine where funds are need most.”

Members of the public making contributions can earmark their donations for a particular island or association, but the trust fund committee needs to know what is being earmarked so contributions are not wasted, Usman added.

Events

“We have received a lot of support from the media, they have been a very, very big help,” said Usman.

A one hour telethon pre-show was broadcast nationwide from June 1 – 7 on four TV stations – MBC, VTV, DhiTV, Raajje TV – and three radio stations – MBC, VTV, DhiFM to raise awareness about the fundraising events.

“The broadcast reports showed where we are, the assistance required, and the grand realities of how the Health Ministry spends their budget,” Usman explained.

The actual telethon was held Saturday ( June 8 ) from 6:00am to midnight. It was kicked off with a sponsored walk along one of Male’s main thoroughfares.

Additionally, two charity football matches were held in Male’s National Stadium Friday (June 7), with Maldivian media presenters facing off against film stars.

The film star women’s team was victorious, winning 4 – 0 , while the men’s media team won 3-0 after dominating overtime penalty kicks.

Proceeds from ticket sales and t-shirt purchases also contributed to the Health Ministry fund.

Furthermore, a Children’s Evening fundraising event was also held at Male’s Children’s Park (Kudakudinge Bageecha).

Donation boxes were also placed at ferry terminals in Male’, as well as IGMH, regional and atoll hospitals.

“Ultimately these events were very successful because we were able to raise so much money,” said Usman.

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IGMH doctors threatened by group of men after not signing for overseas treatment on Aasandha

Indira Gandi Memorial Hospital (IGMH)’s orthopedic department has stopped work after a group of people threatened an orthopedist, seeking a doctor’s note for treatment overseas through the Maldives’ nationwide health insurance scheme ‘Aasandha’.

The person who asked for the doctor’s recommendation to receive medical treatment abroad was first told by IGMH that such a recommendation could not be made because his injury could be treated in the hospital, according to a statement issued by IGMH.

The hospital claimed the man then refused treatment from IGMH.

IGMH said the same person later came into the hospital with a group of 10 men and threatened to attack the doctor, stating that he too would have to seek medical treatment through ‘Aasandha’ if he did not write the recommendation note.

The doctor then filled in the form for the man to receive treatment abroad, according to IGMH.

Aasandha’s free medical treatment is provided only when a doctor completes the special designated form.

The person sought out the doctor during a departmental staff meeting, according to IGMH.

Head of the Orthopedic Department Dr Ali Muznee told newspaper ‘Haveeru’ that in the past doctors have been subjected to such threats individually, but today the group threatened all the doctors working in the Orthopedic Department.

IGMH also said today that they are considering having police officers maintain security in the hospital after the incident.

Minivan News reported in September 2012 the widespread intimidation, fraud and “substandard” treatment by patients, health authorities, local staff and the country’s courts faced by expatriate medical professionals in the Maldives.

One foreign doctor who spoke to Minivan News sat the time said there was a lack of public understanding concerning the scheme and what they were entitled to.

“They become very angry when we tell them that this or that medical condition is not covered by Aasandha. A lot of times they force the management to force us to fabricate a medical condition just to get Aasandha approval,” he said.

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Aasandha opens new customer service office in Male’

Universal health insurance scheme Aasandha has opened a new customer service office to provide improved services to the public, local media reports.

The new office is located on the third floor of STO Trade Centre and will work to solve problems faced by Aasandha customers abroad, medical evacuation issues and checking insurance balances.

The office was opened by Health Minister Dr Ahmed Jamsheed Mohamed.

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