In March 2020, Uganda’s Parliament approved the National Health Insurance Scheme (NHIS) Bill as a means to realize Universal Health Coverage (UHC). However, the bill faced a setback and was referred back to the Ministry of Health to align it with stakeholders’ interests.
The primary objective of UHC is to enhance health outcomes by broadening the access to essential healthcare services for all individuals in need. It also aims to ensure that people seeking healthcare services do not suffer from excessive financial burdens, as outlined by the Ministry of Health.
The NHIS’s introduction is in line with the sixth commitment made during the recent United Nations General Assembly. This commitment focuses on addressing financial risk protection through the implementation of the National Health Insurance Scheme to safeguard households from catastrophic health expenses.
According to Health Minister Dr. Jane Ruth Aceng, this delay in implementing the NHIS has been protracted due to extensive consultations with various stakeholders to accommodate their concerns. Dr. Aceng expressed her thoughts during the 29th Annual Health Sector Joint Review Meeting:
“The National Health Insurance Scheme Bill was initially approved by Parliament, but many of us were dissatisfied with its content. Consequently, when the bill was submitted to His Excellency, the President, for his assent, it was sent back to the Health Sector. After nearly two years of consultations with many of you, the draft bill is now prepared for submission to the Cabinet.”
Dr. Aceng also shed light on several principles integral to the bill. The NHIS enrollment will be obligatory for all citizens aged 18 and above, except for indigents and other vulnerable groups.
Dr. Aceng emphasized that there will be no employer contribution to avoid placing an excessive burden on private-sector employers. This decision was influenced by concerns from manufacturers, unions, private sector entities, and various organizations who did not support the idea of employer contributions.
To maintain the principles of solidarity and affordability, contributions will be segmented according to income groups instead of being based on a percentage of one’s salary, as unions had opposed the percentage-based approach. Dr. Aceng further explained that while indigents will make an annual contribution, others will contribute regularly to support the principle of solidarity and affordability.
Dr. Aceng called on the public to support this initiative, highlighting that Uganda is the only country in the entire East African Region and beyond without an insurance scheme bill. She emphasized the need for public support to mobilize more resources for the health sector. Dr. Aceng stated, “To enhance our healthcare system, we need financial resources, and your support is crucial.”