Contributions to the National Health Insurance Scheme (NIHS) will be made mandatory for all Ugandans, the Government has said.

“Whether you are working or not working, it (contributing to the scheme) is mandatory,” health minister Dr Jane Ruth Aceng says.

She adds that the move will ensure that the quality of service provided is not compromised. The mandatory payment requirement will also act as an incentive for ‘responsible’ utilisation of the services under the scheme, the minister says.

“People do not appreciate services they don’t pay for. But when they get to know that they are paying for this and that, then they hold each other accountable. I know there will be serious debates once the National Health Insurance Bill goes to Parliament, but our stand is that everyone must pay,” she said.

(L-R) Matia Kasaija, the Minister of Finance interacting with health minister Jane Ruth Aceng as Sarah Bireete, the ED Center for Constitutional Governance smiles on. (Photo by Mary Kansiime)

She made the revelation on Thursday during the launch of the Uganda Demographic Health Service report 2022 at the Sheraton Hotel in Kampala.  

Although earlier, the Government had hinged payments on contributions from the working class, the minister said they have since found out that this is not feasible due to the absence of clear parameters on contributors’ income levels and define who is exempted and who is made to pay.

“Some people who are labelled poor in the villages have square miles of land in the villages, some with many cattle on it. Until the Uganda Bureau of Statistics and the Ministry of Finance give us statistics of who is rich and who is poor, it would be hard to tell which income bracket one is,” she said.

According to the minister, contributions to the scheme will be according to the number of dependents one has.

Currently, only about five per cent of Ugandans are covered by health insurance, mostly under corporate arrangement by employers, due to the absence of a National Health Insurance Scheme.

(L-R) Chris Mukiza, the ED UBOS, Jane Ruth Aceng, Albert Byamugisha, the Chairperson Board of Directors UBOS and Susan Ngongi Namondo UN Resident Coordinator launching the Uganda demographic Health Survey. (Photo by Mary Kansiime)

As such, the most common way of accessing health services is to incur the costs out of pocket. For example, when a person falls sick they – or their loved ones – have to pay for medical services and treatment from their savings or sell something, while others take a loan.

However, globally, the World Health Organisation (WHO) has been pushing for universal health coverage.

According to WHO, the goal of universal health coverage is to ensure that all people obtain the health services they need without suffering financial hardship by having to incur out-of-pocket expenses to pay for said services.