The 3rd National Community Health Financing (CHF) conference was held on 8th - 9th November, 2018 at Imperial Royale Hotel, Kampala.

The theme of the conference was ‘enabling effective participation of the informal sector in community health financing and other social protection initiatives.

A total of 189 participants from 28 districts across the country attended the conference. These included members of parliament, senior officials from government ministries, local government leaders, civil society leaders, researchers, academicians, CHF schemes promoters, community health insurance beneficiaries, private companies, and healthcare providers, among others.

Dr Babyo Segun Fatunmbi delivered the keynote address on behalf of the WHO Country Representative while Dr Charles Olaro, the Director Clinical Services in the Ministry of Health officially opened the conference on behalf of the State Minister for Health. Mr Bernard Mujuni, the Commissioner for Equity and Rights in the Ministry of Gender, Labour and Social Development, represented the State Minister for Gender and Culture at the official closing ceremony.

Discussions and outcomes

The presentations and discussions focused on: (1) Current status of community health financing in Uganda; (2) The proposed Luwero District Community Health Insurance Scheme (LDCHIS); (3) The proposed National Health Insurance Scheme (NHIS); (4) Impact of affordable technology and new innovations in managing (collecting contributions, members and benefits) voluntary schemes for the informal sector; (5) Impact of systems, structures and technology for efficient implementation of social protection initiatives in the informal sector; (6) Assessment of strategies employed by governments to make it easy for informal sector families to access community health insurance, National Health Insurance Scheme and other Social Protection initiatives; and (7) Strategies how the informal sector can access community health insurance, National Health Insurance Scheme and other social protection initiatives.

Some of the outcomes/ emerging issues from the conference were:

  1. Create awareness and extend community health insurance (CHI) coverage to all regions in Uganda beyond the current 17 districts covered.
  2. Luwero District local government to follow through the approval of the Luwero District Local Government Community Health Insurance Ordinance 2017 currently with the Solicitor General and Support its implementation.
  3. SHU will work with partners to set up a task team to review the progress of the current NHIS Bill and make recommendation on the most appropriate step to take which may include continued pursuit of the current Bill through to presentation in Parliament or preparation of a private members bill.
  4. Adapt CHI schemes to technology (such as mobile telecom platforms for enrolment and verification of beneficiaries) and to strategies (such as: single bigger pools as opposed to small fragmented ones; having robust target population data bases; categorizing the target population and billing them for insurance equitably) to reduce costs, improve efficiency and move away from expensive ways of running CHI

It was announced that the 4th National CHF conference will take place in November 2019 in Luwero District if the District successfully gets its ordinance approved by the solicitor general and starts implementing the District Community Health Insurance Scheme.

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Finance ministry clears NHIS BillThe Ministry of Finance, Planning and Economic Development has issued a Certificate of Financial Implications for the National Health Insurance Scheme (NHIS) Bill which is projected to start in financial year 2018/2019. The certificate allows the Ministry of Health to present the NHIS Bill to Parliament for discussion.

The certificate dated 7th April 2017 and signed by the Minister of Finance, Planning and Economic Development, Hon. Matia Kasaija, indicates that government and private employees will contribute 4 percent of their monthly salary to the NHIS while employers will contribute 1 percent of each employee’s monthly salary. Self-employed individuals will pay shs100,000 per year while pensioners will contribute 1 percent of their monthly pension payment.

The certificate further indicates that indigents will not contribute to the scheme but will be subsidised by other members of the scheme. It will take 10 years for all indigents to be covered as only 10 percent will be enrolled per year.

Government amends health insurance BillMinistry of Health has written to Finance Ministry seeking a certificate of financial implications after it amended some of the controversial clauses to the National Health Insurance Scheme (NHIS).
The certificate of financial implications shows that there are funds for the implementation of the Bill once it has been passed into law and it is a requirement before any Bill is tabled in Parliament for first reading.

The National Health Insurance Bill 2007, was hatched about 13 years ago and up to date has not been tabled in Parliament.
The Bill seeks, among others, to lower the cost and improve the quality, safety, and efficiency of healthcare in Uganda.
However, if passed into law, the Bill will make it mandatory for civil servants and formally employed Ugandans to make contributions to a National Social Health Insurance (SHI) Scheme.

A letter to the Permanent Secretary and Secretary to the Treasury, Mr Keith Muhakanizi seen by Daily Monitor, indicates that an amendment where only 10 per cent of the indigents or poor people will first be enrolled to benefit from the NHIS as opposed to an earlier proposal to register all the seven million people.
The proposed amendments by the Ministry of Finance also introduce 1 percent deductions from the pensioners’ monthly salary and Shs100,000 annual contributions for the self-employed in the informal sector.