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Abstract
Background: Uganda is in the process of embracing a National Health Insurance Scheme. Stakeholder engagement in identifying key policy concerns, provides a crucial opportunity to use research evidence to address the implementation considerations about this health insurance scheme.
Objectives: To identify priority health systems questions for evidence synthesis for the Uganda National Health Insurance Scheme.
Methods: We invited 54 stakeholders by email, telephone calls and paper letters at least 21 days prior to the priority setting meeting. We purposively selected decision makers and researchers (n = 27) from workers unions, professional associations, healthservice providers, health-related government departments, consumer advocacy groups and non-governmental organizations. We presented participants with a set of documents constituting: a) The National Health Insurance Scheme Bill 2012; and b) a background document outlining the context of the National Health Insurance Scheme in Uganda. We completed three iterations of a mini–Delphi survey technique.
Results: The response rate was 100% for the first two rounds (27/27). We have collected responses from 14 out of 29 respondants for the third round. There were 32 initial policy concerns, which were narrowed to 15 key areas. In this interim analysis, the key concerns were about the: a) range of benefits package, in terms of health care services; b) additional taxation to the formal employees, at 8% of gross salary; c) mode and payment rates to health service providers, particularly government health workers; d) governance of the pooled fund and accountability to the public (corruption) and; e) accreditation to facilitate quality healthcare services across participating healthservice providers.
Conclusions: Our findings suggest that the key policy concerns in implementing the Uganda National Health Insurance Scheme are about mechanisms of financing, remuneration of healthcare workers, governance of the fund and quality of health services. In our next steps, we intend to synthesize relevant research evidence to inform implementation of these policy concerns.
Objectives: To identify priority health systems questions for evidence synthesis for the Uganda National Health Insurance Scheme.
Methods: We invited 54 stakeholders by email, telephone calls and paper letters at least 21 days prior to the priority setting meeting. We purposively selected decision makers and researchers (n = 27) from workers unions, professional associations, healthservice providers, health-related government departments, consumer advocacy groups and non-governmental organizations. We presented participants with a set of documents constituting: a) The National Health Insurance Scheme Bill 2012; and b) a background document outlining the context of the National Health Insurance Scheme in Uganda. We completed three iterations of a mini–Delphi survey technique.
Results: The response rate was 100% for the first two rounds (27/27). We have collected responses from 14 out of 29 respondants for the third round. There were 32 initial policy concerns, which were narrowed to 15 key areas. In this interim analysis, the key concerns were about the: a) range of benefits package, in terms of health care services; b) additional taxation to the formal employees, at 8% of gross salary; c) mode and payment rates to health service providers, particularly government health workers; d) governance of the pooled fund and accountability to the public (corruption) and; e) accreditation to facilitate quality healthcare services across participating healthservice providers.
Conclusions: Our findings suggest that the key policy concerns in implementing the Uganda National Health Insurance Scheme are about mechanisms of financing, remuneration of healthcare workers, governance of the fund and quality of health services. In our next steps, we intend to synthesize relevant research evidence to inform implementation of these policy concerns.