Over 43mln People Covered as Ethiopia Scales up Health Insurance

ADDIS ABABA – The number of people covered by Community-based health insurance (CBHI) has reached more than 43 million, said the Ethiopia Health Insurance Agency.

Ethiopian lawmakers are discussing a draft Community-based health insurance proclamation.

The draft proclamation, the agency says, will be key to further expanding insurance coverage in the country during a discussion with members of the health affairs standing committee of the parliament on the bill on Monday.

The ministry of health launched the Insurance scheme as a pilot project in 13 districts of four regions in 2011.

It was scaled up to a total of 867 districts three years later as health officials quest to achieve universal health coverage in the country.

Growing coverage

To date, the coverage has reached 78% of the entire districts of Ethiopia, enrolling 43 million people in the health insurance system, said Frehiwot Abebe, Director of Health insurance services at the agency.

The number of beneficiaries has jumped by more than 10 million since the end of 2019/20 FY, during which their number was 32mln.

The scheme pools members’ premium payments into a collective fund, which is managed by the members, and covers basic healthcare costs at local health centers when a member is sick.

It aims to ease off the pressure of health-related expenses on low-income households and prevent them from falling into poverty, apart from reducing out-of-pocket payments for health care which often lead to decreased use of health services.

About 3.2 billion Birr have been raised across the nation, said Frehiwot, adding that at least 40 million beneficiaries accessed health services last month alone.

– Focus on Service Quality –

MP Werksemu Mamo, Chairperson for Health, Social Development, Culture and Sport Affairs Standing Committee, said health officials need to give equal emphasis to the quality of service in addition to expanding the CBHI coverage.

Beneficiaries of the CBHI often get access to services at local health centers, and some also go to hospitals following referral.

In response to the MP’s remark, officials said the government is exerting its efforts to improve the quality of the service at the center and hospital level.

More medicines and medical equipment necessary are being provided to the centers to make their services effective, they said.

The ongoing effort also aims to enable public university hospitals located around the country to provide access to people with cancer, heart, and kidney-related diseases to communities nearby, the officials added.

– Performance varies –

Thus far, Frehiwot said encouraging performance has been recorded in Amhara, Oromia, Sidama, and Southern Nations Nationalities and Peoples regionals.

However, the coverage in areas where pastoralist communities live remains below average, admitted Friehiwot.

More work will be carried out to improve the coverage in these areas, she added.

The CBHI proclamation will be key and have a big impact in increasing health insurance coverage at the national level, Frehiwot told the meeting that discussed the bill.

She said the inputs collected both at the pilot and expansion levels show that the CBHI system is bringing encouraging results and achieving its objective. The feedback also indicates that the system should have a legal framework to make its benefits sustainable, she added.

– Eye on Efficiency – 

The CBHI bill proposed to the lawmakers has seven parts with 34 articles, according to the lower house of parliament.

The bill aims to make sure beneficiaries get quality and efficient as well as cost effective health services, according to the agency.

State Minister of health Seharela Abdulahi said the bill will make the CBHI more effective as it includes a range of mandatory provisions to make service providers and officials in charge of follow up of the system function better.

Some of the provisions, for instance, will help to hold health workers disciplinary issues accountable, and respond to complaints of the beneficiaries, according to the state minister.

The standing affairs committee of the parliament has scheduled more discussions on the bill in the coming days, before taking it to the house for ratification.

[Featured Image Ehia/File]