During the seventh health insurance stakeholders’ conference, there was a strong call for the government to urgently revisit the regulation process in the health sector to prevent a crisis in healthcare delivery. Held at Protea Hotel in Entebbe and spanning four days, concluding on Friday, the conference gathered stakeholders from community and commercial health insurance sectors, healthcare professionals, academics, the Federation of Uganda Employers, and representatives from the Ministry of Health and local governments.
They converged under the theme, “Toward Universal Health Coverage in Uganda through Expanding Private and Community Health Insurance Schemes.” Expressing disappointment, the stakeholders highlighted the rejection of an earlier bill by the President that aimed to provide a regulatory framework for the sector. They emphasized that the current Insurance Act of 2017, under which health insurance falls, lacks specificity to adequately address the country’s healthcare challenges.
Efforts to establish a more targeted legal framework faced obstacles when the President declined to approve the Health Insurance Bill of 2021. Save for Health Uganda (SHU), a not-for-profit organization, now advocates revisiting this effort to tackle the substantial health issues, particularly affecting impoverished communities. Dr. Elizabeth Ekirpa-Kiracho, an expert from Makerere University Institute of Public Health, emphasized the need for a mandatory healthcare insurance policy but highlighted the necessity of a legal framework to implement it effectively.
She noted that private providers’ high premiums often excluded the poor, and while Community-Based Health Insurance seemed promising, it also faced challenges serving those unable to afford even minimal premiums proposed by these schemes. She cited countries like Peru, Costa Rica, and Ghana, where the government covers healthcare for all citizens or those unable to afford it.
Highlighting the stark statistics, Fredrick Makaire, Executive Director of SHU, pointed out that only 3.9 percent of Ugandans have health insurance, leaving the majority to bear their healthcare expenses out of pocket, creating a significant burden, especially for the less privileged. Dr. Nakimuli Leticia Irumba, SHU’s board chairperson, stressed the urgency of supporting the poor who are unable to access healthcare services due to financial constraints, constituting 41 percent of Ugandans outside the formal economy.
Rutahibwa Elisa, representing the Parliamentary Health Committee, reiterated the necessity of health insurance as an alternative solution in light of challenges such as drug theft, inadequate infrastructure, and personnel shortages in the national health system. He expressed Parliament’s readiness to support a new bill after the President’s rejection of the 2021 bill, citing the need for a robust regulatory framework.
Minister Margaret Muhanga Mugisa acknowledged the healthcare bottlenecks and hinted at a new bill in progress following the President’s rejection of the earlier one. She emphasized the need to prevent avoidable diseases and criticized societal complacency towards health risks like smoking, alcohol consumption, and poor dietary choices.
Muhanga highlighted concerns about population explosion, teenage pregnancies, and the associated health burdens. “Population explosion is another big problem I see causing us health problems. Somebody cannot look after one child but continues giving birth as if children are wealth. This is one area where we have disagreed with His Excellency. A big population per se is not a market. We have to address the issue of quality first,” she said. She emphasized the need for quality healthcare and indicated challenges in introducing contraception due to resistance from religious leaders and moralists.
Sponsored by USAID, the Federation of Uganda Employers, Uganda Insurers Association, Uganda Protestant Medical Bureau, SMART, and the Ministry of Health, the conference continued its discussions until Friday.
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