Center for Health Market Innovations (CHMI)

Programs

Nyakibale Hospital Health Plan

last updated Jul 6, 2012

Overview

Implementing organization: 
Nyakibale Hospital
Implementation Partner(s): 
Uganda Health Co-operative,Uganda Community Based Health Financing Association (UCBHFA)
Legal Status: 
Private (not-for-profit)
Year Launched: 
1999
Stage: 
Existing/expansion stage
Income Level of Target Population: 
Bottom 20%, 20-60% (lower to lower-middle)

Funding

Primary Source of Funding: 
Membership/subscription fees
Additional Source(s) of Funding: 
Donor
Funders: 
Cordaid

Scale

Personnel Employed: 
10-49
Number of Clients Served: 
approximately 120,000 (catchment area)
Summary: 

Nyakibale Hospital Health Plan is a microinsurance scheme that covers families for in-patient and out-patient services in rural Uganda.

Program goals/rationale: 

The program aims to encourage health seeking behavior and make good quality health care accessible to the local people.

Key program components: 

The scheme membership mainly comprises of peasant farmers, small scale traders, teachers and students. It covers in-patient services including malaria and typhoid treatment, general ward costs, operations, and deliveries; out-patient services include laboratory tests, tooth extractions and eye care among others. Members pay a quarterly premium for which a family of 1 to 4 people pays Ug. shs 7000 (US$ 2.92) with any additional person paying Ug. shs 2000 (US$0.83). The premiums are paid to scheme leaders who then submit them to the scheme offices. The scheme involves co-payment for outpatient services of Ug.shs 1000 (US$ 0.42) per visit and inpatient services of Ug.shs 4000 (US$ 1.67). Upon discharge, the payment is made to the hospital cashiers and it reduces the scheme treatment costs.

The scheme uses membership cards and family photographs to mitigate fraud. The hospital uses standard treatment protocols and provides services according to those included in the package to control for cost escalation. The provider sends out the treatment bills, which are reconciled with the scheme records, and then the payment is processed on a monthly basis.

The program involves the community members in mobilization and sensitization around the insurance scheme. At quarterly meetings, the community decides on the premiums and collects them; they also raise funds for income generating projects. Health education campaigns are also carried out to educate the people about the prevention of diseases such as malaria. CORDAID occasionally supports the mobilization and sensitization campaigns.

Program history: 

Nyakibale Hospital Community Health Plan was started in 1998 with funding from the DFID through UCBHFA under the auspices of Ministry of Health. CORDAID came in through Health Office Kabale Diocese, and unfortunately due to government policy, DFID stopped its funding. Recruitment into the scheme is based on existing structures like" Engozi groups" (burial groups), micro finance institutions, schools, religious groups and any other group that may be well organized.

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