The government of Ethiopia has been working persistently to access health care services for all with affordable prices by devising and implementing Community-Based Health Insurance and a Social Health Insurance System, which would provide healthcare coverage for all citizens engaged in both in the formal and informal sectors of the economy and secure them from financial burden in case of illnesses.
According to the Health Insurance Service Ethiopia document, the health insurance program is one of the progressive approaches that Ethiopia is making notable strides in the health sector in the past decade plus years by providing fair and accessible healthcare services to citizens.
And as many people agree, since it has become operational, the program has created remarkable opportunities for a number of low-income communities who could not afford to pay and get healthcare services.
The Ethiopian Herald approached Expert at the Ethiopia Health Insurance Service Wudu Lakew to learn the progress made so far regarding the implementation of health insurance services in various parts of the nation.
According to him, the government recognizes the importance of health insurance as a means of protecting individuals from the high cost of healthcare services while also ensuring that the health sector is financially sustainable. In return, the program that was commenced as a pilot program has now scaled up and become a fully-fledged program in which millions of Ethiopians are benefitting from the program.
When the program was first initiated nationwide, the number of people who were utilizing the services was limited for various reasons; one amongst the many was having insufficient knowledge about the benefits of the program.
Currently, following the repetitive awareness creation works, the number of people has shown steady increments and the amount of money collected from the population is increasing. The number of health facilities has also augmented. Today, millions of urban and rural communities are benefitting from the pregame, he reiterated.
For instance, at the beginning, the service was provided in 13 woredas with 125,000 households; approximately 546,331 population in 57 health facilities. But now, it has shown significant strides and one thousand woredas, with 12 million households approximately 56million citizens are able to benefit from the services. It is also made possible to generate 6 billion Ethiopian Birr for the program working with 3459 health facilities.
The sustained and continuous awareness creation efforts made among the population regarding the multilayered benefits of the health insurance system has produced successful results in implementing the program.
According to him, the program helped in increasing health service utilizations, improving financial protection and delivering quality of care as well as equity in health finance service utility. Moreover, the program helped to increase health facilities revenue and it improved citizens’ access to quality healthcare services, both in the hinterlands as well as the urban areas.
The community-based health insurance program called the Community Health Insurance Scheme (CHIS). This program is designed to provide health insurance coverage to low-income individuals living in rural areas. The CHIS is financed through a combination of community contributions and government subsidies. The government provides subsidies to cover the cost of health services that are not covered by the community contributions.
The government has also been working to increase the affordability of health insurance programs by offering subsidies to individuals who cannot afford to pay for coverage. This has helped to make health insurance more accessible to low-income individuals and families.
As to him, the Health Insurance Service Ethiopia is working with pertinent stakeholders with high commitment to improving the health system and increasing public awareness about the importance of health insurance are critical steps towards achieving universal health coverage. With continued investment and effort, Ethiopia can build a sustainable health insurance system that ensures that all citizens have access to quality healthcare services.”
“The Ethiopian government has implemented several policies and programs to make health insurance more affordable for low-income individuals. One of the key strategies is the use of subsidies,” he underlined.
To harness the performance and expedite further the government has established a program called the Health Care Financing Reform (HCFR) that aims to provide financial protection to low-income individuals by subsidizing their health insurance premiums. Under this program, the government provides subsidies to individuals who cannot afford to pay for health insurance coverage on their own. The subsidies are targeted towards individuals who fall within the lowest income brackets.
In addition to these programs, the government has also been working to improve the overall affordability of health insurance by introducing cost-sharing mechanisms. For example, the government has implemented co-payment arrangements where individuals are required to pay a small percentage of the cost of healthcare services they receive. The government has also introduced out-of-pocket expenses, which limits the amount that individuals are required to pay for healthcare services.
To make sure that the program expands it coverage and becomes more effective, the collaborative activities amongst different stakeholders and sectors is fundamental
Responding to inquiries of the challenges in translating the program to the ground he underlined one of the challenges faced in implementing a health insurance system in Ethiopia is the lack of awareness and understanding about health insurance among the population. Many individuals are unfamiliar with the concept of health insurance and may not understand the benefits of enrolling in a health insurance program. This lack of awareness can lead to low enrollment rates and hinder the efforts exerted to make healthcare services more accessible.
The other challenge is the lack of infrastructure and resources in the health system. It is obvious that shortage of healthcare facilities and trained healthcare professionals in various parts of the nation is challenging the effort. The implementation of a health insurance system requires a well-functioning health system, which can be difficult to achieve in a country with limited resources.
To address these challenges, the Health Insurance Service Ethiopia has been working with media and communities focal persons and idea makers. The efforts are bearing fruit and it is helping to increase awareness about health insurance programs and to improve the infrastructure and resources in the health system.
He concluded, the government is striving to invest in the construction of new healthcare facilities and has been training more healthcare professionals. Additionally, the government is keeping on working to increase public awareness about the importance of health insurance through public campaigns and other initiatives.
BY MENGISTEAB TESHOME
The Ethiopian Herald July 30/2023
