Why the NHIS is essential in achieving universal health coverage in Uganda

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What you need to know:

...there is an urgent need to fast track the passing of the NHIS Bill into law and immediately start on its full implementation to guarantee equity, accessibility...

Uganda has made noticeable progress towards achieving Universal Health Coverage (UHC), which is a cornerstone for the attainment of Sustainable Development Goal three on the global development agenda.

However, with only seven years to the deadline, a lot more needs to be done to achieve this target. Among the things that Uganda can exploit to achieve Universal Health Coverage – enabling the population to have access to a full range of quality health services they need, when they need it, without financial hardship – is implementing the National Health Insurance Scheme (NHIS).

The NHIS seeks to provide affordable healthcare to all residents in Uganda to ensure social security because access to affordable healthcare is one of the most important components of social security.

Access to quality healthcare remains a big challenge for many residents in Uganda, especially in rural areas and the urban poor. Majority are struggling with high out-of-pocket health expenditures which has deprived many from accessing health care service, some consider selling their assets to raise funds for treatment.

Even with free health services at public facilities, limited resources at these facilities makes it hard for most people to access healthcare services.  This also explains why out-of-pocket expenditure in Uganda is still high (38.3 percent) as compared to the global average of 18 percent, according to the World Bank, and some neighbouring countries such as Kenya (24.06 percent), Tanzania (23.10 percent) and Rwanda (11.7 percent). Rwanda has successfully implemented the National Health Insurance Scheme (NHIS).

By its nature, however, the NHIS is designed to pool funds to provide access to quality and affordable health care services for all residents in Uganda based on their health needs.

The major aim of this National Health Insurance Scheme is to protect residents in Uganda from unexpected and high medical costs by allowing them an opportunity to pay affordable premiums and get treatment when and where they need it without financial hardships.

Currently, health insurance has demonstrated the ability to avert financial risks that arise from high out-of-pocket expenditure on health, thereby contributing to a reduction in impoverishment.

Health insurance is one of the major contributors to the growth of the insurance industry in Uganda, medical insurance contributed Sh321.3b which accounts for 22.3 percent of the industry’s gross written premium according to the 2022 performance results.

Despite such a remarkable increase in medical insurance gross written premiums, health insurance in Uganda remains very low, at 0.8 percent according to the National Service Delivery Survey 2021.

We are, however, optimistic that the planned implementation of the NHIS will ensure universal access to healthcare by all Ugandans and consequently increase insurance penetration, from less than 1 percent currently. It is anticipated that the scheme will provide a platform to address most of the health challenges that have affected low-income earners and the unprivileged Ugandans.

Thus, there is an urgent need to fast track the passing of the NHIS Bill into law and immediately start on its full implementation to guarantee equity, accessibility, and affordability of healthcare for all residents in Uganda.

Mr Kepha Kato is a research officer at the Insurance Regulatory Authority of Uganda.