Designing innovative pro-poor healthcare financing system in sub-Saharan Africa: The case of Eritrea

Abstract

This study attempts to develop a pro-poor health care financing system for Eritrea. The study seeks to answer the following question: can the rich and healthy subsidize the poor and sick in Eritrea? This question is directly related to issues of social insurance and universal coverage. This study was conducted in 2016 in six months period from February to August. In this study, both primary and secondary data sources were used. Interviews were conducted with 35 key health officials and stakeholders. In this study, it is found that lack of purchasing power and financial resources; insufficient knowledge of health insurance schemes and high transaction costs; and lack of supply and information about care possibilities are the main problems for the development of a viable healthcare financing system in Eritrea. As the Ministry of Health is embarking on new pricing and cost recovery strategies, a closer look of its effects on consumers is required, particularly on the poor and vulnerable groups. Significant increases in revenues from user fees increases may not be realistic, given the country’s high poverty rate. The health care financing policy needs to be assessed in light of current and projected health sector needs. Key words: Eritrea, health care financing, Sub-Saharan Africa, health policy, health insurance.