National Health Insurance stakeholder consultations begin in Zim

By Kuda Pembere
The Health and Child Care Ministry has commenced consultative engagements with stakeholders for the implementation of the National Health Insurance, a much expected and mulled over for 25 years health insurance product.
At a time when over 90 percent of the country are uninsured health-wise, this NHI comes in designed to pool funds to provide access to quality, affordable basic health care services for the population of Zimbabwe according to their health needs, irrespective of their socioeconomic status.
Speaking to journalists on the sidelines of the stakeholders’ engagement meeting, Health Ministry Permanent Secretary Dr Aspect Maunganidze said there will be another one for the Southern Region.
“Yes, so we are meeting today at the Harare International Conference Centre, where we are starting with the roadmap in terms of having our National Health Insurance. This is a scheme that should be taking care of the whole population, especially those who are vulnerable.
“And we are looking at more than 90% of our population, which cannot afford to be on the medical insurance as it exists today. So one of the first steps that we have to do is what we have started today, which is a stakeholder’s engagement. We have planned to have two of these, one in the northern region, followed by one in the southern region,” he said.
He added that the NHI also comes in to reduce the out-of-pocket expenses that Zimbabweans endure.
“And that will then come up with a concept note for principles that our minister will be able to take through the processes of coming up with a New Act in terms of national health insurance.
“You might be aware that most progressive countries have gone through this and the latest is South Africa where they now have comprehensive national health insurance.
“We started this process earlier than South Africa, more than 25 years ago. So, we now want to make sure we implement, and this is the first step in the implementation strategy.
“The importance of this is that you’ll be able to have universal health coverage. And access to health is very important at all layers of our health system. So, the national health insurance reduces the out-of-pocket expenses of our population and thus make them more economically productive.
“And this dovetails very well with what our present vision 2030, which we now want to accelerate to 2028. Without a good health, your economic activity or productivity levels are low,” Dr Maunganidze said.
Policy and Planning Department Acting Director in the Health Ministry Tonderai Kadzere explained that the NHI will be compulsory.
“So, in national health insurance, we are looking at a pooled fund on a compulsory basis that is going to procure health care services.
“But I think like what has been said, the guidance is that it’s not going to be based on direct contribution like the one that you do to your own medical aid, but I think this one we are looking at probably based by an indirect contribution.
“Maybe through earmarked taxation like VAT and a lot of these things. So what that means, everyone contributes.
“So, I think there are also negotiations, of course, considering our fiscal space. Already we have got such funds like the Health levy fund and others.
“So, the national health insurance now brings all these together in one pool so that we can buy together and covering the basic healthcare services,” he said.
He noted that the NHI will be working alongside private medical aid players.
“So already it will also exist with the private insurance. So, like what we said, we are proposing maybe if it buys 80 percent of what happens in a district hospital, so it means that medical aid societies that are in existence, they will then cover the complementary package.
“So I think basically it is on solidarity purposes and we are very confident that the environment is very conducive for us to do that.
“And like what we said, health is the basis for everything. So I think even in the end, yes, we’d find out that it’s one of the strategic pillars, health and well-being. So I think it is in that regard that we do that,” Kadzere said.
Also to be pooled into the NHI include the proportions from Diaspora remittances tax, Voluntary Organizations/Partner/NGO Contributions, Community Based Health Insurance (collapsed into the NHI), Mineral Export Taxes (Sovereign Wealth Fund), Investment of the available NHI fund, Health Impact Assessment earnings (Public Health Act), as well as Proportion of War Veteran’s Fund.
The Association of HealthCare Funders of Zimbabwe’s (AHFoZ) board chairperson Mr Stanford Sisya said while they welcome the initiative, the NHI should be implemented in a phased approach.
“As AHFOZ I think we are supportive of this initiative for National Health Insurance. I think for us there is an issue that we believe that this should be a phased approach for it to be sustainable. And we have got proposals around how best it can be by age, or by service, it can be various scenarios, it can be mixed bag, but we believe we can actually achieve this if we go through the phased approach route,” he said. “For AHFoZ, I think we stand in support as we are also part of the technical committee that will be implementing the national health insurance. So, we are also closely looking at the Essential package that has been proposed by the ministry to see how best this can fit in terms of the products for the private sector. And we believe that we should be able to come up with something which is quite sustainable.”
The Community Working Group On Health (CWGH) executive director Mr Itai Rusike also commended the Health Ministry for the efforts to introduce this much yearned NHI.
“National health insurance is critical for the achievement of Universal Health Coverage (UHC). This is important in a country where currently 7 percent of Zimbabweans have medical insurance. Mo country has made significant progress towards UHC without increasing reliance on public revenues. Mobilizing domestic public funds is therefore essential for UHC,” he said.
He also called for proper management and governance of the NHI.
As you know public funds do not managed proplerly. As CWGH we continue to advocate for zero tolerance for abuse of funds for the success of this NHI. We have had some instances of people abusing public funds but we expect the pooled monies to be used for its intended purposes,” he said.
Also present at the meeting were officials from the Business Sector, the World Health Organization, the United Nations Children’s Fund (UNICEF), Consumer Council of Zimbabwe amongst others.

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