Strategies to bridge the huge gap –

Medical health insurance is important to scale back the monetary burden of buying well being care by pooling funds and sharing the dangers of surprising well being occasions. Danger-sharing mechanisms are notably necessary in Sub-Saharan Africa (SSA) the place most nations allocate inadequate assets to well being care and most well being care, together with medicines, is out-of-pocket funded.

In Africa, 27 out of 48 nations are most affected by out-of-pocket funds (OOPs) for healthcare providers. WHO Regional Committee for Africa Undertake a regional well being financing technique that recommends the event of pay as you go plans to broaden medical insurance protection and cut back out-of-pocket funds.

Closing this hole in entry to medical insurance is essential to attaining the aim of common well being protection, which is to make sure that everybody has entry to the high-quality well being care providers they want, with out the chance of economic damage or poverty.

Why is medical insurance necessary?

The advantages of satisfactory and sustainable medical insurance protection in Africa are quite a few. They embrace enhancing the provision and affordability of important medicines; growing entry to care and defending households from the opposed financial results of in poor health well being; Present protection for inpatient care to alleviate the sudden large monetary burden attributable to hospitalization; Making certain elevated entry to important medicines and offering an incentive for applicable use; Progress in direction of common well being protection (UHC).

Sadly, in Africa, there may be nice disparity in entry to medical insurance, with formal staff and rich folks having fun with higher alternatives than casual staff and the poor and weak teams. Closing this hole in entry to medical insurance is essential to attaining the aim of common well being protection, which is to make sure that everybody has entry to the high-quality well being care providers they want, with out the chance of economic damage or poverty.

The Nationwide Well being Insurance coverage Scheme (NHIS): A mannequin for attaining broader and equitable medical insurance protection in Africa

A latest examine revealed that though medical insurance in sub-Saharan nations is very inequitable, a big proportion of the inequality lies in non-public types of medical insurance versus publicly owned medical insurance plans. Non-public medical insurance plans that require people to make a contribution to be able to entry advantages, choose increased socioeconomic people, and thus reinforce inequality.

Evaluating 36 sub-Saharan nations, the examine confirmed that the highest three nations with the best medical insurance protection and the least quantity of inequality are Rwanda, Ghana and Gabon. These three nations have publicly owned medical insurance methods which might be funded largely by taxes, fairly than counting on voluntary contributions.

It’s clear that sub-Saharan African nations won’t obtain the specified medical insurance protection, therefore UHC makes use of de facto voluntary medical insurance as a scheme for well being financing. African nations ought to undertake publicly owned nationwide medical insurance plans that keep in mind the poor and weak.

Case research: Rwanda and Ghana

Different African nations can study from the few nations on the continent which have quickly elevated their medical insurance protection and are characterised by inequality in medical insurance protection. In Rwanda, CBHI is managed centrally by a nationwide authorities company, is necessary for all members of the casual sector and covers greater than three quarters of the nation’s inhabitants.

Beneath the scheme, all of the poor obtain full state subsidies, whereas some members of the casual sector obtain partial subsidies. The scheme is basically funded by non-contributory mechanisms (donor funding and common taxation).

Ghana has one of the superior healthcare methods in Africa because of the common insurance coverage system often known as the Nationwide Well being Insurance coverage Scheme (NHIS). Earlier than the general public insurance coverage system, Ghana used a “money and carry” scheme that required fee for any remedy up entrance, which prevented many individuals from accessing care.

Ghana’s medical insurance price is among the many highest in Africa, making the nation the most effective on the continent, when it comes to a complete healthcare system.

As of 2021, practically 70% of Ghana had medical insurance protection. NHIS in Ghana is primarily funded by a mixture of presidency allocations from common tax income and an earmarked tax (2.5% of VAT and a pair of.5% of social safety contributions).

Nigeria is making efforts to enhance medical insurance protection

Nigeria is making nice efforts in its journey to common well being protection. In Might 2022, a brand new Nationwide Well being Insurance coverage Authority (NHIA) regulation was signed into regulation. This act makes medical insurance obligatory for all Nigerians.

It establishes and permits the NHIA to make sure the availability of medical insurance to all Nigerians by a compulsory mechanism in cooperation with state medical insurance businesses. This might imply that greater than 70% of Nigerians who pay out-of-pocket healthcare prices, a lot of whom fall into poverty because of this, can profit from obligatory medical insurance on the nationwide degree.

Learn additionally: 5 charts displaying the allocation of the FG Fund to Major Well being Care in 2022

An necessary level to notice is that the NHIA Act gives for the creation of a brand new fund for weak teams. The Weak Teams Fund will present medical insurance protection subsidy for weak folks and pay medical insurance premiums for the indigent. Therefore, members of the group within the casual sector and weak teams will get pleasure from medical insurance protection.


In gentle of this, it’s clear that medical insurance in Africa continues to be growing. Studying classes from nations like Rwanda and Ghana, different African nations must undertake NHIS and guarantee broader and equitable medical insurance protection of their nations, as this can be a non-negotiable path in direction of attaining common well being protection on the continent.

Anyakura is the CEO of Bloom Public Well being and an professional in public well being and

Odibeli is a pharmacist and analysis and communications coordinator at Bloom Public Well being