Several states are actively working towards the implementation of Universal Health Care (UHC), but face legal and political obstacles, leading to delays and challenges. Kenya, for instance, witnessed President William Ruto approving four Health Bills in October, laying the groundwork for an overhaul of the country’s UHC program. The creation of the Social Health Authority (SHA) and the replacement of the National Health Insurance Fund (NHIF) with the Social Health Insurance Fund were key aspects of this initiative.
However, legal hurdles emerged as the Kenya Medical Practitioners, Pharmacists, and Dentists Union obtained court orders to halt the planned rollout of the new Social Health Insurance (SHI) Fund Act. The government has appealed the decision, with the court set to decide on January 19. Even if the orders are lifted, the transition from the 57-year-old NHIF to the new scheme poses logistical challenges.
A Harvard University study defines Social Health Insurance (SHI) as a financing model that mobilizes funds and pools risks to ensure healthcare access for the poor and near-poor. In Kenya, households are expected to contribute 2.75 percent of their income, amounting to a projected Ksh57 billion ($357.4 million) annually to the Social Health Insurance Fund.
Despite the government’s intentions to improve healthcare accessibility, the transition period has caused confusion and adverse effects on some Kenyans. Students, previously covered by the NHIF-backed EduAfya Medical Scheme, are left without coverage, causing financial strain for those with chronic illnesses seeking medical treatment abroad.
In Tanzania, President Samia Suluhu Hassan advocates for the swift implementation of revised National Health Insurance Fund (NHIF) rates to achieve Universal Health Coverage (UHC). Despite the passage of the UHC Bill in November 2023, opposition from private service providers has stalled the NHIF rate revision. President Samia emphasizes the inevitability of health insurance, with about 15 percent of Tanzanians currently covered.
Uganda faces challenges in implementing its national health insurance scheme, despite the bill being passed in March 2021. President Yoweri Museveni sent the bill back to parliament for reconsideration, citing concerns about the vague implementation framework. Disagreements over whether the poor should be required to pay and the lack of a regulatory framework further complicate the situation. Uganda’s current health expenditure relies heavily on out-of-pocket costs, making the implementation of a national health insurance scheme critical.
The region grapples with varying challenges, including legal impediments, logistical complexities, and concerns about the practicality of proposed health insurance models. As these nations strive for Universal Health Care, effective implementation, transparency, and addressing the diverse needs of the population emerge as pivotal factors in achieving this crucial healthcare goal.
