Zambia: Understanding the National Health Insurance Scheme

DID you know that in a population of nearly 16 million Zambians, only 3.9 per cent have access to health insurance?

This translates into an estimated 15.4 million people in Zambia that have not been insured to access health services.

'He, who has health, has hope, and he who has hope has everything', says an Arabian proverb.

Although health is one of the fundamental requirements of life; it is barely given the space it deserves.

In many cases, it has become difficult to value health despite it being a symbol of human wealth.

Recently, there has been dissent against introduction of a National Health Insurance Scheme with some people arguing that it should not be made compulsory while others have expressed ignorance of its benefits.

According to the analytical brief on social budget for 2018 by the Zambia Institute for Policy Analysis and Research (ZIPAR), more Zambians will access universal health coverage once the social health insurance scheme is implemented.

Patriotic Front (PF) Committee on Health vice chairperson Jonas Chanda said in an interview that statistics show that 15.4 million Zambians have no form of health insurance, meaning when those people fall sick, they are on their own when it comes to paying for health services.

Dr Chanda said for one with a serious ailment to have no health insurance means parting away with colossal sums of money to get the required service.

"Let's say if you need an operation that costs K15,000 or even K120,000, if you are without insurance, you or your family will have to look for that money," he said.

He said one would either look for money through borrowing, selling of property or getting a loan to get the desired healthcare service, which is different when one has health insurance.

"There will be people that will contribute more according to their ability but the most vulnerable in the society, like those recipients of social cash transfer, the elderly and most disabled, will not contribute because they obviously have to be taken care of," he said.

Dr Chanda said contributing something towards health is called risk pulling because the share of risks has to be done and through the health insurance scheme, a card would be issued with contributions made according to one's ability.

There would be no charge when implementing treatment whether at a private or public healthcare centre.

He said at the point of delivery of health services, people would not pay anything because they would have been contributing through the scheme.

He said people today are hesitant to seek medical assistance because of the amount of money that comes with treatment.

But with the national health insurance, most of the things are covered and a patient just has to produce a card.

Dr Chanda said the national health insurance is in line with the global health policy and is not something that the Government came up with.

He said it is a global health agenda which demands universal health for all.

Dr Chanda said irrespective of social status, everyone is entitled to healthcare, which is a right and not a privilege.

He said it is also linked with the Sustainable National Development Goal (SDG) number 3.8 which talks about providing universal healthcare for all.

Dr Chanda said countries like Rwanda have successfully implemented the health insurance scheme with 96 per cent of Rwandese covered by the national health insurance.

He said countries like Ghana and Tanzania have also incorporated the health insurance scheme.

He said 54 years after gaining independence, Zambia has to implement the scheme for the betterment of its citizen's health wise.

"Let's cover our people. They don't have to pay from their pockets or wait until they are very sick to go and see a doctor. They can be treated quickly," he said.

Dr Chanda said in terms of the mixed feelings expressed by some people over the health insurance scheme not being a standalone kind of initiative.

He said such people fell that the scheme should be part of social protection where the ministry of Labour and Social Security took health as part of the pension.

Government has taken a position that the national health insurance scheme should be a standalone programme because health is a specialized field.

Dr Chanda said in terms of the mixed feelings, most trade unions unions actually supported the National Health Insurance Scheme though the Zambia Congress of Trade Unions (ZCTU) has opposed it.

He said trade unions, such as Zambian Union of Allied workers (ZULAWU) are in support of the introduction of the scheme.

On February 20, ZULAWU issued a statement supporting the Bill and the National Union of Private and Public Educators of Zambia (NUPPEZ) Executive President Victor Muyumba went on to support the Bill as much as the Basic Educators Union of Zambia (BETUZ) who endorsed the importance of the Bill.

Under ZCTU, the Zambia National Union of Teachers supports the health insurance scheme, reason being that it is already part of their Collective Agreement signed with Government.

In the interest of the workers and their families, the scheme comes in handy.

Marble Kasonde, a Ndola based mother of eight, said the scheme is a welcome development because it will cover family members registered under the health insurance.

Ms Kasonde said: "If all Zambians are registered and the national health scheme becomes compulsory, many poor families will benefit because Government has a duty to ensure that the citizenry all have quality access to basic services such as clean water and healthcare services."

Charity Kasonde, a trader at Chifubu market in Ndola, shared the sentiments raised by Ms Kasonde when she contended that the scheme will go a long way in ensuring that people have access to health services without delay.

Ms Kambole, a widow taking care of four orphans, said the scheme is a deliberate stride by Government to empower people with access to facilities and healthcare services.

"As a widow, I look after children alone and there are cases where I am not able to seek healthcare services because the treatment and medication is beyond my income.

"To me, the scheme is being introduced in good faith for the benefit mostly of poor people who cannot afford specialised medical treatment," she said, with a sigh of relief.

The Abuja Declaration says a percentage should be directed towards health budget by every government in Africa, including the Zambia.

In that regards, the national health insurance scheme should be looked at from the two main objectives of increasing access for every Zambian to healthcare service and improving financing to the health sector which would aid in meeting the target of having a 15 per cent budgetary allocation, and even more, as demands the Abuja Declaration.

In many ways, the health insurance scheme brings extra resources to push Zambia towards meeting the Abuja Declaration of having 15 percent of the budget allocated to the health sector.

More From: Times of Zambia

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