MINISTERIAL STATEMENT ON THE IMPLEMENTATION OF THE NATIONAL HEALTH INSURANCE SCHEME.

 Presented to the National Assembly

 by Hon. Sylvia T Masebo, MP

 

Minister of Health,  July, 2024

 Madam Speaker

I appreciate this opportunity to update the Members of the House on the Implementation of the National Health Insurance Scheme which has, since April 2024, reverted to the Ministry of Health in line with government’s agenda of strengthening health systems for enhanced health service delivery for all citizens and established residents.

Access to good quality healthcare for all citizens and established residents is the vision of the New Dawn Government under the Excellent leadership of the Republican President, His Excellency Mr. Hakainde Hichilema.

The Ministry of Health is spearheading this agenda by ensuring that our people are provided with quality health services as near as possible to where they live, go to school, and work without encountering any financial hardship.

The role of NHIMA in our national healthcare system is a critical one in pooling financial resources for the sustainable financing of health care services.

Through this statement I wish to update the House on the implementation status of the Scheme in meeting its objectives as per the National Health Insurance Act No. 2 of 2018 and the reforms that are being embarked on to ensure that all citizens and established residents are registered onto the Scheme and that the Scheme remains solvent in meeting its obligations.

Madam Speaker,

NHIMA was created pursuant to the National Health Insurance Act No. 2 of 2018 whose mandate includes, among others, the following to:

1. Register and issue membership cards to members.
2. Accredit/register health care providers.
3. Develop a comprehensive benefit package to be accessed by members.
4. Facilitate access by poor and vulnerable people to insured health care services.
5. Receive, process and pay claims for services rendered by accredited health care providers.
6. Undertake programs that further the sustainability of the Scheme.

Madam Speaker,

Access to NHIMA services is by registration. It is therefore important that all citizens and established residents register to be members of the Scheme.  Citizens and established residents should not wait to fall ill before they can register. Citizens and established residents between 18 and 64 years should be registered as contributing members on the Scheme both from the formal and informal sector. Children below 18 years should be registered as beneficiaries under a principal contributing member. Those aged 65 years and above are exempt from making contributions.

A citizen and established residents who is mentally and physically disabled and is unable to work, a person classified as poor and vulnerable by the Ministry of Community Development and Social Services are exempt from making contributions to the Scheme.

Madam Speaker,

NHIMA contributions are pegged at 2% of Basic Income for those formally employed, split equally at 1% between the employer and employee. For those in the informal sector, the contribution is at an average of K50 per family per month to cover up to 7 members. Access to services for all members and their registered beneficiaries is uniform and is not limited to how much a member has contributed.

Madam Speaker, When the New Dawn government came into power, the membership of NHIMA stood at 1. 6 million members and beneficiaries. As of June 2024, NHIMA members and beneficiaries stands at over 4.6 million. This Madam Speaker is a clear reflection of the New Dawn’s administration aspiration of leaving no one behind.

Madam Speaker,

The current NHIMA contributions are the lowest of any health insurance Scheme, averaging only K50 per family of 7 members per month as alluded to. With this minimal contribution, NHIMA members can access all the services they need under the NHIMA benefits package comprising of the following:

1. Outpatient Services,
2. In patient Medical Care including consultations, examinations, Diagnostic services (Radiology and laboratory) and Nursing Care,
3. Surgery: General Surgery, Anesthetics, Orthopedics, Pediatric Surgery and Ear, Nose and Throat,
4. Maternity and Neonatal Care: Antenatal Care, Delivery (Normal or Assisted), Caesarean Section and Postnatal Care,
5. Eye Care Services: Selected services,
6. Oral Health Services,
7. Pharmaceutical Drugs and Medical Supplies such as Blood products and;

All these services are offered to our members without having the need to pay at the point of access. This is the value that NHIMA brings to its members, and it is the responsibility of all of us to register to access these benefits.

Madam Speaker,

The current membership of over 4.6 million mentioned, represents only 23 percent of the Zambian population. Our goal as government through NHIMA is to ensure that all citizens and established residents are covered. Therefore, Madam Speaker, it is only through registration, and making the NHIMA contributions that a member and registered beneficiaries can access services.

In this regard, Government through my Ministry and working with NHIMA has embarked on a National wide NHIMA Registration Exercise that was launched on Friday 5^th July 2024 in Ndola District. This campaign is aimed at increasing membership to the Scheme in our drive towards Universal Health Coverage. Registration of members is being done at all public hospitals, NHIMA offices country wide and online through the NHIMA website. To ease the process, Madam Speaker, NHIMA has put in place a toll-free line 8000 where members and the public call for assistance.

Madam Speaker,

To encourage the registration of members of the public, NHIMA has for the month of July 2024 introduced a special waiver where those who register and make their monthly contributions will not have to wait for the mandatory 4 month required before accessing services. Madam Speaker, Effective 5^th July to 4^th August 2024, all NHIMA members that will be registered and make their contributions will be able to access services immediately. For purposes of sustainability of the Scheme, it is important, that members remain current with their NHIMA contributions.

Madam Speaker,

To further enhance the registration, Government through NHIMA has partnered with Global Fund, and International Labour Organization and launched the registration of over 100,000 Social Cash Transfer Beneficiaries as NHIMA members. To this effect, 10,000 beneficiaries were registered in Ndola during the official launch and eligible to access health services under NHIMA. This partnership Madam Speaker only provides for 100,000 members and beneficiaries against the 1.3 million currently catergorised as poor and vulnerable by the Ministry of Community Development and Social Services.

Madam Speaker, we have a mammoth task, and we therefore call upon other co-operating partners to come on board and support NHIMA in this exercise of onboarding the remaining poor and vulnerable.

Madam Speaker,

Access to NHIMA services can only be through NHIMA accredited health facilities. It is the government’s desire that every NHIMA member must have access to a NHIMA accredited health facility that is located as close as possible to their place of residence, work or school to facilitate convenient healthcare access. Currently, NHIMA has 406 NHIMA accredited facilities spread across the country. To ensure that every Zambian has access to a NHIMA facility near them, government has directed NHIMA as follows:

1. That each district of the country has a NHIMA accredited health facility and NHIMA registration presence.
2. That NHIMA accreditation is not restricted to only District Level Hospitals and those higher, but that Mini Hospitals and Zonal Health Centres in sub-districts should be all accredited. By so doing, this will bring NHIMA services closer to the people. This strategic step will contribute significantly to expanding healthcare coverage to currently under served and unserved communities. As a result of this, over 30 more Mini Hospitals and Zonal centers are undergoing onboarding, and members can now access services from these facilities.
3. That NHIMA prioritizes the accreditation of all Government hospitals throughout the country as these serve most of our population.
4. That NHIMA enhances its registration exercise to cover all citizens and established residents, particularly those in the informal sector as well as the poor and vulnerable.

 

5. That NHIMA works with local authorities in the nationwide registration process for those in the informal sector.

Madam Speaker,

Being a contributory Scheme, NHIMA’s financial sustainability is of key importance for it to achieve its health financing objectives. Since NHIMA’s return to the Ministry of Health, several policy reforms have been devised and are under implementation to keep its financial health in check. Among the key reforms are the following:

1. Launching a mass registration exercise to cover the informal sector and extend the NHIMA collections coverage wider.
2. Suspension of the accreditation of new private healthcare providers. This is aimed at ensuring that priority is given to financing public facilities that service the bigger part of the population.
3. Revocation of accreditation for health facilities involved in health insurance fraud. This is to safeguard public funds and ensure value for money.
4. Reviewing the NHIMA benefits package.
5. Reviewing the financing modalities to enhance NHIMA’s collections capacity.

These reforms are all aimed at ensuring that NHIMA stays afloat and achieves its objectives of being a sustainable healthcare financing mechanism for government.

Madam Speaker,

Let me emphasize that the UPND government places high importance on health as a human right that every one of us is entitled to. Investing in health, therefore, is an important undertaking in ensuring that the health rights of citizens are enjoyed.  In this regard, Government through the Ministry of Health working with NHIMA Management will ensure that all citizens and established residents are part of NHIMA, irrespective of their socio-economic status. I am confident that the NHIMA Membership Registration drive that has begun will substantially drive progress towards the achievement of Universal Health Coverage.

Madam Speaker,

 

As I conclude, let me re-emphasize the following key points:

1. NHIMA is for every citizen and established resident, including the formal and informal. Therefore, everyone must be registered as per the law.
2. The services that a member can access are not limited to their contributions but their health needs because it is an insurance Scheme.
3. Government has provided for mechanisms to cover for the vulnerable groups.
4. One does not have to wait to be sick to register for NHIMA, everyone must register before they fall sick.
5. We urge all stakeholders to come on board and support government efforts towards this drive.

My clarion call to members of this August House is to engage their communities, including local authorities and drive the registration of all their constituents as members of NHIMA.

Madam Speaker, I thank you