Benefits Package For Anambra State Health Insurance Agency (Ashia)

S/N Primary Level Care

1. General consultation by qualified medical personnel with prescribed drug from accredited primary health facility or Pharmacy.

2.Health prevention and promotion Education Family planning education with or without provision of commodities (Safe period, Pills, Condoms)
Dental care HIV/AIDS
Routine Immunization as specified in the NPHCDA guideline
Vitamin A supplementation
Promotion of essential nutrients for children and pregnant women
Promotion of personal, domestic and environmental hygiene
Health education on Non-communicable diseases e.g Hypertension, Diabetes Mellitus.

3. Primary Surgery

Minor Surgical Procedures:
Incision & drainage, suturing of lacerations, minor burns, simple abrasions Minor wound debridement Circumcision of male infants Evacuation of impacted faeces Corrections of cases of simple polydactyl Drainage of simple paronychia Relief of urinary retention by catheterization

4. Primary eye care including treatment of: Conjunctivitis
   Parasitic and allergic ailments
   Simple contusion, abrasions and others as may be specified in the guideline from time to time
5. Primary Paediatrics

Child Welfare Services-Growth monitoring, Routine immunization as defined by the NPHCDA, Vitamin A supplementation, Nutritional advice and health education and others as may be specified in the guideline from time to time
Management of uncomplicated malnutrition Treatment for Helminthiasis
Treatment of common childhood illnesses such as malaria, diarrhoeal disease, upper respiratory tract infections, UTIs, simple otitis media, simple skin diseases/infestations and other viral illnesses such as mumps
Other febrile illnesses as may be listed from time to time by the Anambra State Health Contributory Scheme ASHCS guidelines
Treatment of anaemia not requiring blood transfusion
Screening and routine drug administration for sickle cell disease

6. Primary Internal Medicine (Adult) A Management of simple infections/infestations
   Malaria Respiratory tract infections
   Urinary Tract Infections
   Gastroenteritis Primary Ear, Nose and Throat infections Diarrheal diseases Enteritis/ typhoid fever
   Helminthiasis Skin infections/infestations such as Chicken pox and fungal diseases e.g T. vesicolor, M. furfur, T. Capitis, etc
   Scorpion Bites Other uncomplicated bacteria, fungal, parasitic and viral infections and illnesses

B. Management of simple anaemia (not requiring blood transfusion)

C Screening/referral for Diabetes Mellitus, Hypertension and other chronic diseases

D Treatment of simple arthritis and other minor musculoskeletal diseases

E Screening and routine drug administration for sickle cell disease
F Simple allergies

8. HIV/AIDS/STDs
   Voluntary Counseling/Testing

9 TB Suspicion/Referral for diagnostic testing/Follow up AFB Microscopy test

10 Primary Psychiatry

Anxiety neurosis
Psychosomatic illnesses
Insomnia Other illnesses as may be listed from time to time by the ASHIA

11 Special Maternal, Neonatal and Child Health (MNCH) Services
Antenatal care Routine ANC
Referral services for complicated cases

b. Delivery services
Spontaneous Vaginal Delivery by skilled attendant including repair of minor birth injuries and episiotomy Essential drugs for Emergency Obstetric care (EmOC)
c. Postnatal services
d. Newborn Care up to 6 weeks. (Cord care, Eye care, Management of simple neonatal infections)

12 Emergency

The Primary Healthcare Provider (PCHP) is to offer First Aid treatment before referral.
Establishing an iv line
Management of convulsion
Control of bleeding
Cardio-pulmonary resuscitation
Assisted respiration (e.g. Ambu bag)
Immobilization of fractures (using splints, neck collars)

13. Basic laboratory investigations
    MP
    Widal
    Urinalysis
    Hb, FBC
    Stool physical examination/microscopy
14. Other conditions as may be listed by ASHIA from time to time

S/N
SECONDARY LEVEL CARE

1. Consultation and treatment by specialists
2. Emergency cases outside place of residence within the state in an ASHIA accredited Health Care Facility
3. Admission maximum of 15 days cumulative per year for medical admission, maximum of 30 Days cumulative for surgical admissions cumulative per year to be paid by the ASHIA
4. Procedures that cannot be handled at primary level of care such as

A. HIV/AIDS and TB
Provision of Anti-retroviral drugs and Anti-TB medicines (BY GOVERNMENT AGENCY)

B. Paediatrics
Treatment of Severe infections/infestations-Respiratory infections, UTIs, diarrheal disease with moderate to severe dehydration, enteric fever, severe malaria, septicaemia, meningitis, severe measles, etc
Management of childhood non-communicable diseases such as Nephritis, etc
Management of severe anaemia requiring blood transfusion
Management of neonatal infections-Neonatal sepsis,
Neonatal conditions such as birth Asphyxia, Neonatal jaundice, Management of child from Diabetic mothers, etc

C. Internal medicine (Adult)
I) Treatment of moderate to severe infections and infestations
Management of severe malaria
Management of meningitis, septicaemia, etc.
Management of complicated RTIs
Management of complicated typhoid fever, etc
Management of complications of TB (limited to conditions covered elsewhere in this package)
II) Management of non-communicable diseases
Management of Diabetes and Hypertension (Use Pharmacy or drug supply by ASHIA)
Management of Sickle cell disease
Treatment of severe musculoskeletal conditions
Liver diseases (Hepatitis, Cirrhosis, Amoebic liver abscess).
Management of severe anaemia
II) Treatment of snake bites

D. Secondary Psychiatric Care such as Electro Compulsive Therapy, management of Psychoses such as schizophrenia, etc.

E. I) Basic and Comprehensive Emergency Obstetric Care
Management of Preterm/Pre-labour Rupture of Membrane (P/PROM)
Detection and management of hypertensive diseases in pregnancy
Management of bleeding in pregnancy – Abortion and Complications, APH, PPH.
Caesarian section
Operative Management for ectopic gestation
Management of intra-uterine fetal death
Management of Post-Abortal and puerperal sepsis
Instrumental deliveries
High risk deliveries – 1st deliveries, Beyond 4th deliveries, multiple pregnancy, mal-positioning/mal-presentation and other complications, etc
Multiple Deliveries

II) Gynaecological Intervention
Bartholin cystectomy
Colporrhaphies

F. Surgeries
Management of urinary retention by suprapubic cystostomy
Appendicectomy
Hernia repair
Hydrocelectomy
Management of Testicular Torsion
Management of Fractures excluding internal fixation

G. Dental care
Simple and surgical tooth extraction

H. Ophthalmology
Removal of foreign bodies
Refraction, including provision of spectacles not exceeding N5000

I. Ear, Nose & Throat
Antral wash-out
Foreign body removal

5. Laboratory investigations at secondary level of care

A. Genotype
Lumber puncture
Urea/electrolyte/creatinine
Bilirubin (total and conjugated)
Ketone bodies
M/C/S-Urine, Blood, stool, Sputum, Wound, Urethral, Ear, Eye, Throat, Aspirate, CSF, HVS
Occult blood in stool
Skin snip for microfilaria
Blood groupings/Cross matching
Hepatitis B surface Antibody screening
Confirmatory test for HIV
FBC
Platelets count
Prothrombin/thromboplastin time
Blood transfusion services including donor screening and blood bag

B. Radiology–X-ray of chest, Abdomen, Skull & Extremities, Dental X-rays, etc
Abdominopelvic & obstetric scan