The Ministry of Health in Uganda is proposing a revised National Health Insurance Scheme that would require every adult Ugandan to contribute 15,000 shillings annually (about US$4).
The original bill, passed by parliament in 2021, was withdrawn by the government due to gaps that needed addressing after consultations with stakeholders.
However, concerns have been raised about the affordability of the proposed contribution for many Ugandans. To address this, the Ministry of Health plans to collaborate with Village Health Teams (VHTs) to assess individuals’ ability to contribute.
The ultimate aim of this initiative is to achieve Universal Healthcare Coverage (UHC) and provide quality and affordable healthcare to all Ugandans. Nevertheless, there are challenges, including low awareness about health insurance and misconceptions that services will immediately improve once the scheme is in place.
Speaking during an event to launch an eight-year strategy aimed at achieving Universal Healthcare Coverage by 2030 by AMREF Uganda on Friday, Margret Muhanga Mugisa, the Primary Health Care Minister, said that even as the bill was bounced back, politicians are still fighting to frustrate the scheme. She said politicians are now saying Ugandans can’t afford to pay the suggested annual contribution of Fifteen thousand shillings (Ushs 15,000).
Shortly after being passed by parliament in 2021, the bill that was supposed to facilitate the introduction of the national health insurance scheme was controversially withdrawn by the government citing gaps that needed to be addressed after thorough consultations with stakeholders.
Now, Muhanga says they will soon table the revised bill before the cabinet but according to Prof Elizabeth Ekirapa, a Health system specialist based at Makerere University School of Public Health even as there have been many attempts to introduce the public insurance scheme, there is currently very low awareness about health insurance and its benefits in the country.
Ekirapa says sections of the public wrongly believe that once the insurance scheme comes into place, the population will immediately get better services and yet it will take some time for the service to be improved.
Dr. Githinji Gitahi, the CEO of AMREF Health Africa, emphasizes the need for continuous mapping and assessment to determine who can afford the contribution, considering the changing poverty levels, especially as a significant portion of the population is employed in the informal sector.
He suggests the use of Village Health Teams (VHTs) to determine those that can afford the annual contribution and this he says has to be a continuous process because poverty levels keep changing.
Meanwhile, US$ 150 million has been set aside to finance the newly launched strategy, which among others aims to improve access to health services, improve health education and come up with climate strategies to tackle climate change which in the end will lead to achieving universal healthcare coverage.
With about 40 percent of Ugandan households relying on out-of-pocket expenses to finance healthcare, and at least 1.5 million Ugandans pushed into poverty due to health care expenditure, financing healthcare remains a significant concern.
Currently, Uganda and South Sudan are the only countries in the East African Community without an NHIS. Rwanda, in contrast, boasts 95 percent health coverage, highlighting the need for progress in Uganda’s healthcare system.