| dc.description.abstract | Introduction; The study set out to establish how effective community health insurance is in improving health care. The main objective was to evaluate the effectiveness of CBHI schemes in improving access to health care in Uganda. The specific objectives were to determine the coverage of the scheme in terms of region and services covered, to establish the level of financial leverage to the members and to determine the level of clients’ satisfaction. Community health insurance schemes are voluntary arrangements organized at community level to pool resources for health care, particularly amongst the informally employed. It is aimed at improving financial access to health care through prepayment. The HSSP proposes use of CHI as a means of funding and improving health care. There is, however, no evidence that this arrangement has led to the betterment of health care access and the study was conducted to establish this.
Methodology; A cross sectional descriptive study was carried out in Bushenyi region among people who had been enrolled into community based health insurance schemes for at least six months. A total of 250 respondents were involved in a face to face interview. Both primary and secondary data was used.
Findings; From the twelve schemes studied, the study revealed that for the majority of the people, the package paid for covers health education, family planning, outpatient and inpatient services, but excludes chronic illnesses, major surgery and self-inflicted injuries. The majority of the respondents were peasant farmers and dependent on small scale sales on their farms for income to make premium payments and cover other costs like the transport and copayment upon service utilization. Many felt that much as the premium fee was fair for the services received, they would prefer to pay a smaller fee than is currently being charged. Respondents felt services were satisfactory and the benefit derived was ranked high. They however noted several challenges such as the fact that health facilities are far away therefore demoralizing at times of need, and hence people being un able to get to the facilities to be served. Members suggested the Government gives them a hand by offering some money that will cut down on the premium and also to build more facilities so that services are brought closer to the people.
Recommendations; The researcher recommends that more effort be put into sensitizing communities on the role of CHI so that the knowledge gained facilitates them in making informed decisions on joining upon realization of benefits that accrue with the insurance plan. It is also recommended that the government supports sustainability of these schemes through provision of funds that would help reduce premium costs while allowing the rural people participate in their own health financing. This needs to be coupled with increased health facilities that should be well staffed and equipped. Also, timing for premium payment needs to be synchronized with the harvest season to ease payment since the majority of the members are peasant farmers and thus reliant on sales from their produce.
Areas for further research; The researcher suggests, as further areas of study: the timing of premium payment and collection, the reasons for drop out from schemes and role of CHI in rolling out of the proposed NHIS. | en_US |
