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 17 years ago in 2002:
“17 years of drafting, discussions, negotiations and engagements,”
said Hon. Dr. Jane Aceng, Uganda’s Minister of Health.
Living Goods has been part of the journey to bring this bill to fruition together with several line ministries and partners. However, the work is not done. With Cabinet’s approval, the bill will be gazetted and sent to the Parliament of Uganda for debate, 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 for other things. Poverty is increasing in some communities and out-of-pocket expenses on health is one of the leading causes of this. 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 NHIS will be composed of three sub-schemes including the Social Health Insurance (SHI), the Community Based Health Insurance (CBHI), and the Private Commercial Health Insurance (PCHI) 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.
Dr. Diana Nambatya Nsubuga
Deputy Country Director, Community Health Partnerships
Dr. Nsubuga is an accomplished public health professional with expansive experience in health systems strengthening and community health programming in ten African countries, including Uganda and Ethiopia. She has developed partnerships with more than 40 organizations. Prior to joining Living Goods, she served as the Country Manager for Global Health Corps. She holds a Ph.D. in Public Health and has won several leadership awards. She has also served as an Honorary Associate Professor at Makerere University as part of her community service.