On June 24, 2019, the Cabinet of Uganda approved the National Health Insurance Scheme (NHIS) Bill 2019, achieving an important milestone in delivering health for all. The approval is a significant accomplishment as discussions around the bill started over 17 years ago:

“17 years of drafting, discussions, negotiations and engagements,”

said  Hon. Dr. Jane Aceng, Uganda’s Minister of Health.

Living Goods participated in the journey to bring this bill to fruition along with several line ministries and partners. However, the work is not done. With the Cabinet’s approval, the bill will be sent to the Parliament of Uganda for debate, recommended amendments, and approval for enactment. Dr. Michael Bukenya, Chairperson of the Parliamentary Health Committee, together with his executive, will lead debating and requests for additional amendments so that the bill is approved for enactment.

Ugandans spend a significant amount of their income on health, which reduces their ability to save and spend on other things. Because of high out-of-pocket expenses spent on healthcare, poverty is increasing in the most vulnerable communities in Uganda. According to the National Health Accounts Report for 2014/15 to 2015/16 financial years, “even with free services at public facilities, the share of household expenditure spent in public health facilities was between 14.1% and 17.5% in the period under review.”

The NHIS bill will help protect Ugandans from financial hardship when seeking services. The bill is composed of three sub-schemes, including social health insurance, community-based health insurance (CBHI), and private-commercial health insurance, which will be implemented concurrently. The CBHI will largely comprise of the informal sector.

The Certificate of Financial Implications by the Ministry of Finance, Planning and Economic Development shows that the government and private employees are to contribute 4% of their monthly salary to the NHIS while employers will contribute 1% of each employee’s monthly salary. Self-employed individuals are expected to pay 100,000 Ugandan Shillings per year and pensioners to contribute 1% of their monthly pension payment.

According to the Certificate of Financial Implications, the government will continue to fund the provision of free health services in health facilities until every Ugandan is enrolled in the NHIS. It will also continue to fund public health interventions and other specialized services outside the standard benefits package and other health system investments such as major infrastructure, human resources, specialized medicines, and technology at a reducing scale as a contribution to NHIS increase.