Franchise of HEFAMAA Monitoring Activities

The Agency is empowered by the Health Sector Reform (HSR) Law 2006 to franchise some of its activities. Section 49 (5) of the Law granted the Agency the power to select franchise companies to monitor, inspect and ensure compliance with the law by all health facilities in the State.

The Agency was able to visit 1,534 health facilities in the year 2019. In the year 2020, the Agency visited 1,566 health facilities at least once out of a total of 3,670 registered health facilities as a result of the inadequacy of staff and other constraints. Thus, it has been a herculean task for the Agency to effectively monitor all health facilities in the State. The franchise of monitoring activities is a means to improve monitoring effectiveness in the healthcare system of Lagos State. A more effective monitoring of health facilities in the State will help to eliminate quackery which will in turn improve the delivery of qualitative health services to the residents of the state and also allow qualified health care practitioners to have valuable returns from their investments.

The Franchise companies will act as “fact-finders”. They will visit health facilities for monitoring, gather facts, document and then forward their reports to the Agency for decision making and action.

The Agency sought and obtained the Approval of Mister Governor and due process was followed throughout all the stages of the procurement process; evidenced by the issuance of a Letter of No Objection for the advertisement of the Franchise by the State Public Procurement Agency (PPA). An advertisement was placed on the PPA website and the Procurement Platform to request for EOI from interested organisations to which twenty one (21) private organisations responded. The organisations went through preliminary and technical evaluations after which eight (8) franchise companies were adjudged to be successful. The Agency had also received Certificate of Compliance from the PPA.

Remuneration of the private franchise organisations would be carried out as stipulated in section 51(6)(a),(b) and (c) of the Health Sector Reform Law of 2006. The Law states as follows: “(6)all monies paid for registration shall be payable into an account to be managed by the Agency; and (a) the Agency shall retain 30 per cent for its running costs; (b) the Agency shall pay 50 per cent to the franchise company or agent; and (c) the Agency shall retain the remaining 20 per cent to be paid as bonus in the first quarter of the new year to the franchise company or agent who brought in the revenue based on performance.”

“Money paid for registration” in the above context refers to the “Registration fees” paid by new health facilities that have applied to the Agency for registration as well as funds accruing to the Agency from the annual revalidation of the licenses the Agency has issued to health facilities which enables them to operate legally in the State’. This does not include funds accruing to the Agency from the processing of the application for licensing by new facilities which comprises:

1. Payment for application form
2. Payment for Registration Certificate
3. Payment for Identification Logo

The processing of Application Form, Registration Certificate and Identification Logo will continue to be undertaken by HEFAMAA and are not included in the franchise.

HEFAMAA is starting with the franchise of monitoring activities. The inspection of facilities that applied for registration will continue to be undertaken by the staff of the Agency with the assistance of private consultants in various specialties who shall be engaged by the Agency as required.

The Terms of Reference for the Engagement of the Franchise Companies states that the staff complement for the monitoring activities should include professionals with the requisite skills and a minimum of 5 years post qualification experience. Each team will comprise of:

1. A medical doctor with the requisite skill and experience who shall be the Team Lead
2. A double-qualified Nurse
3. A medical laboratory
4. Any other relevant health worker.

The Franchise companies will have a list of consultants in the various sub-specialties from which they can engage the required consultant when they need to monitor specialist facilities. The consultants may be engaged by the franchise companies either on full-time or part-time basis.