Arua residents root for health insurance scheme

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ARUA

The majority of Ugandans are grappling with out-of-pocket healthcare expenses, and a considerable number of patients needing such services are unable to afford them. Access to affordable health care is one of the most important components of social security.

This, therefore, calls for healthcare financing through insurance to ensure accessibility. However, there is no national health insurance coverage, which would cover those who cannot afford out-of-pocket health expenses.

Health insurance is where an insurance company agrees to pay for some or all of a person's medical expenses in exchange for a monthly premium payment. The insurance company then contracts different service providers ranging from hospitals, clinics, pharmacies from where the insured persons can access medical services. Only insurance companies and Health Membership Organisations licensed by the Insurance Regulatory Authority of Uganda provide health insurance services in Uganda.

Although Parliament had passed the National Health Insurance Scheme (NHIS) Bill in March 2021, the health ministry withdrew it to undertake more consultations. The conversation on the NHIS remains a subject that everyone should be interested in partly because health insurance coverage is low, estimated to be under 0.5% of the Gross Domestic Product.

In Arua city, the matter of medical insurance policy attracts mixed reactions from the public.

Jay Bruz Ayiko Innocent, a resident of Awindiri ward in the city's central division, says: “It is high time that Uganda took this matter critically and emulates developed countries. This is what we need to do so we can enjoy being Ugandans by saving towards health insurance for future health emergencies".

Hamza Safi from the central division is ready to welcome the initiative, which is expected to be compulsory.

Safi encourages the youth, who can afford, to think about embracing health insurance for their future health emergencies.

“Sometimes, one may get involved in a serious car crash and lacks money [for the medical bill] but if they have health insurance cover, this can be of great help,” Safi says.

Realising health insurance cover's importance

However, Arua City ghetto youth president, Swaleh Taban, says health insurance is mostly for the wealthy.

According to him, given the high poverty rate among many Ugandans, it becomes difficult to pay for health insurance except when one is well-to-do.

“For us in Uganda, money speaks a lot and if you don’t have it and have no connections, life is complicated. Because of this we only realise the importance of saving for sickness when we are seriously ill simply because we are poor,” Taban says.

According to Ronald Oria, a data collector, many people are still ignorant about medical insurance. Oria says people should learn to save incrementally to meet the target for health insurance.

“Many of us look at health insurance as a waste of money that we urgently might need for other purposes. Insurance is an important aspect of our lives because you can save little consistently and eventually, the gains are bigger. We need more sensitisation,” Oria said.

An ailing nation cannot develop

During the 125-year Jubilee Inaugural Ceremony and Annual Health Assembly at Kampala city-based Rubaga Training School Health in February this year, health state minister, Hanifa Kawooya, said the NHIS Bill had reached its final stages. She cautioned that a nation cannot progress with an ailing population unable to afford healthcare, emphasizing that the Bill signifies an improvement in health services.

In Uganda, approximately 39% of healthcare expenditure is out-of-pocket, falling below the international threshold target of $86 (sh316,128) per person set by the World Health Organisation. Without health insurance, achieving universal health coverage is challenging, as recognised by the WHO.

Health Minister, Jane Ruth Aceng, stated that families would contribute at least sh15,000 monthly per household member to the health insurance pool if the proposed National Health Insurance Scheme Bill is approved by Cabinet.

Sensitisation needed

Annet Queenie Nyati Adriko, the executive director Living Plus Haven Uganda, encourages the Government to implement the scheme.

Annet Queenie Nyati Adriko, executive director Living Plus Haven Uganda. (Credit: Robert Adiga)

She, however, calls for massive sensitisation on the importance of the scheme before it can be rolled out.

Similarly, mental health expert Daniel Dratibi Drileba, the Executive Director of Voice of Restoration International, says he support efforts to implement the NHIS.

Dratibi, however, says there is a need to also take up the matter of mental health insurance seriously because of the number of people who are experiencing mental challenges is high.

According to Twaweza’s sauti za wananchi 2017-2023 survey, only 2% of Ugandans reported having health or medical insurance, well below Kenyans (32%) and Tanzanians (26%).

In 2019, only two per cent of women in Uganda had access to health or medical insurance compared to three per cent of men in the same year.

According to Insurance Regulatory Authority chief executive officer, Ibrahim Kaddunabbi Lubega, the uptake of health insurance is less than 1% in Uganda.

Uganda’s current health insurance options are employer or community-based schemes and are estimated to cover less than 2% of the population.