Joint regional health protection a good move

In July this year, regional healthcare players gathered in Kigali with an aim of assessing the feasibility of harmonising the various national health insurance systems, as part of the East African Community integration agenda. The move, if successful, would see citizens of the five member states (Rwanda, Burundi, Uganda, Kenya and Tanzania) get health care anywhere (in the region) under a uniform billing system. The development, among other things, was inspired by previous resolutions like the 2011 World Health Assembly in Geneva and the 2010 World Health Report, stipulating that everyone should have access to health services without having to suffer from financial hardship in the process. Quite similarly, in recent years, there has been an increased global push to ensure delivery of universal health coverage(UHC) -- creation of reforms that ensure everyone, everywhere, can access quality health services regardless of their financial status. For instance, earlier this month, a global coalition of more than 500 leading health and development organisations converged in New York, to urge governments to spearhead the implementation of UHC. The event also saw the launch of first-ever Universal Health Coverage Day. This kind of move was a long awaited one, considering that each year, 100 million people world-wide fall into poverty because they or a family member becomes seriously ill and they have to foot the medical bills. And around one billion people worldwide cannot even access the health care they need, paving way for disease outbreaks to become catastrophic epidemics. For a region like East Africa, that’s prone to disease and poverty, ensuring health and wellness would call for a progamme like a Social Health Protection (SHP). Currently Rwanda tops the region in health insurance coverage, standing at about 73 per cent, followed by Burundi with 65 per cent , Kenya with 32 per cent, Tanzania 19 per cent, while in Uganda it stands at less than 1 per cent. Experts say that harmonised health insurance will ensure a healthier and more productive EAC population currently estimated at 141.1 million. Rwanda’s community-based health insurance programme (Mutuelle de Santé) has been the focus of several studies and much debate in regional and global health policy. EAC partner states therefore with low health insurance coverage need to conduct more research and learn from countries like Rwanda which comparatively fair well, and also carry out massive sensitization in respective area of jurisdiction. More in that line, a July 2014 report by Global Health Issues and Solutions (GHIS), a local research firm, out to assess the feasibility of harmonising SHP systems in the region, recommends that partner states should design local and transparent systems to identify the poor who need to be subsidised by the government. For instance for a country like Uganda ,because of lack of a community based health insurance system, the number of people who sell their property to clear medical bills had risen from 4 per cent to 26 per cent in the last three years. Creation of a successful regional SHP programme also calls for harmonised regional training and provision of incentives to healthcare providers. “Creating a task force that will be charged with advising respective governments and sharing best practices on social health protection system is necessary,” the GHIS says. The GHIS partners with schools like the University of Rwanda’s School of Public Health, Tanzania’s Ifakara Health Institute, Makerere University’s School of Public Health in Uganda, Burundi’s Institut National de Sante Publique and Nairobi University in implementation of the programme. In conclusion, integration should go beyond strengthening the implementation of the common market, and also honour the right to health and welfare of citizens.