In a decisive move to safeguard its most vulnerable citizens, the Delta State Government has issued a stern warning against illegal charges for healthcare services. Dr. Isaac Akpoveta, Director-General of the Delta State Contributory Health Commission (DSCHC), announced that beginning January 2026, any health officer found collecting money from pregnant women or children under five years old in state facilities will face sanctions. This enforcement action targets a persistent barrier to care, where informal fees often deter families from seeking essential medical services, despite existing policies.
The policy, mandated by Governor Sheriff Oborevwori, provides comprehensive free care. This includes all antenatal visits, delivery (both normal and Caesarean section), and postnatal care for pregnant women. For children, it guarantees free treatment from birth until their fifth birthday. “The goal is to eliminate financial fear as a factor in maternal and child health decisions,” Dr. Akpoveta stated. He linked the policy to a significant drop in maternal and child mortality rates already observed in the state, highlighting the life-saving potential of removing cost barriers.
However, the announcement goes beyond a simple directive. The state is implementing a multi-layered strategy to ensure compliance and sustainability, recognizing that past free-care initiatives have often failed due to lack of enforcement and funding.
The Digital Backbone: Ensuring Transparency and Accountability
A critical component of this initiative is Delta State’s pioneering use of Information Communication Technology (ICT). The DSCHC has deployed a digital monitoring system—the first of its kind in Nigeria—to track service delivery in real-time. This system includes facial identification for enrollees to prevent fraud and ensure the right patients receive free care. Every medical bill and prescription is transmitted electronically from the facility to the commission, creating an auditable trail.
“We monitor the entire process from over 530 accredited health units across the state,” Akpoveta explained. This digital oversight is designed to achieve two main objectives: first, to instantly identify facilities that illegally charge patients, and second, to streamline reimbursement to hospitals for services rendered, ensuring they are not financially burdened by the free care policy.
Carrots and Sticks: Incentives and Sanctions for Facilities
To further drive compliance, the commission has designed a dual mechanism of rewards and penalties. Health facilities that perform credibly under the scheme will be recognized and rewarded through a dedicated award program. Conversely, “erring officers” will face sanctions. This structured approach aims to align the interests of healthcare providers with the policy’s goals, moving from voluntary compliance to an accountable system.
To prepare the ground, Governor Oborevwori has mandated training for all medical doctors and Officers-in-Charge of hospitals and Primary Healthcare Centres (PHCs). These trainings, held every three months, drill down on the specifics of the no-charge policy. Mr. Ifeoma Ekpo, a PHC officer from Ika North Local Government who attended the training, pledged on behalf of her colleagues to abide by the new rules, reflecting the top-down enforcement approach.
Funding the Future: The Quest for Sustainable Universal Health Coverage
Governor Oborevwori has approved over N3.5 billion for the contributory health scheme this year, demonstrating significant financial commitment. The scheme itself has seen remarkable growth, expanding from 1.3 million enrollees at its inception in 2017 to over 2.7 million as of December 2025, maintaining its position as Nigeria’s leading state health insurance scheme.
Yet, officials openly acknowledge that government alone cannot bear the full cost of universal health coverage. In a strategic appeal, Dr. Akpoveta called for private sector and philanthropic partnerships. “Wealthy individuals and private organizations can buy health insurance for the vulnerable,” he said, noting that an annual premium for the scheme can be as low as N7,000 per person. This model allows communities, religious groups, and associations to sponsor coverage for their less privileged members, creating a community-supported safety net.
The ambitious target for 2026 is to use this fortified system to reduce the disease burden for covered conditions—like typhoid and malaria—by up to 80% across the state. By integrating strict enforcement, digital transparency, continuous training, and a blended funding model, Delta State is attempting to build a replicable framework for free maternal and child healthcare that is not just a pronouncement, but a functioning, accountable reality.
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