Feasibility of Community Health Insurance in Ediofe and St Assumpta, Arua District
[1]
Philip Govule, Faculty of Health Sciences, Uganda Martyrs University, Kampala, Uganda.
[2]
Maria-Pia Waelkens, Université Libre de Bruxelles, Brussels, Belgium.
Taking a decision on whether or not to begin a Community Health Insurance (CHI) scheme needs checking whether conditions are favorable or not. This is done through the process of a feasibility study that generates information to determine whether the necessary conditions for establishment of a successful CHI scheme are present, and if so, which scheme design is most appropriate in the local context. This article describes the feasibility study carried out in the catchment area of St Assumpta Medical Centre and Ediofe Health Centre III, Arua District, Uganda. The main subjects of enquiry were health seeking behavior of the target population; their ability to pay; premium calculation; and background information needed to guide decision-making. Following onset of illness, 53% of respondents go to the private-for-profit clinics, shops and pharmacies as their first health seeking action. Only when there is no improvement, more turn to government and private-not-for-profit health services. Overall, people swiftly seek care when ill, but tend to delay when admission is needed: 70.5% of inpatients had been ill for 5 days before seeking care. Although majority of the people in the study are regarded as poor, most households are able to pay the calculated premium. The steering committee should take informed decisions about scheme design and implementation that will ensure a viable scheme responding to people’s needs. Seeking to provide the best possible care at the lowest possible fees, much can be done to standardize treatments and fees, in discussion with care providers.
Feasibility Study, Community Health Insurance, Health Financing, Uganda
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