A Critical Analysis of Challenges and Prospects of the National Health Insurance Scheme in Zambia-A Case Study of Lusaka District

Abstract

Zambia’s National Health Insurance (NHI) was established by the enactment of the NHI Act No. 2 of 2018 and supported by statutory instrument No. 63 of 2019 which led to the establishment of the National Health Insurance Scheme (NHIS) under the management of the National Health Insurance Management Authority (NHIMA). The goal of the NHIS was to guarantee the provision of universal health insurance coverage for all residents, regardless of their socioeconomic status. As one of the prospective financing solutions for protecting populations from high health care service prices, NHIS is receiving increased attention from the international community. This study set out to investigate the difficulties and opportunities that the plan faces from the standpoint of the service providers and subscribers in Lusaka, Zambia. The study used the descriptive research design since it seeks to analyze the prospects and challenges of the national health insurance scheme in Lusaka, Zambia. The study came to a conclusion that in Lusaka, Zambia, consumers who wish to utilize the NHIS plan face challenges related to health literacy and awareness, fraud, and corruption, as well as, subpar service quality. The survey also discovered that consumers in Lusaka have difficulties with enrolment and registration while attempting to use the NHIS program due to intermittent availability and constant breakdown of the NHIMA system. The study further came to conclude that some of the prospects for the NHIS plan in Lusaka is public knowledge and involvement, enhancing monitoring and evaluation of the private and public health facilities accredited with NHIMA and improving the internet connectivity of the NHIMA system to enhance service delivery.