Pros and Cons of National Health Insurance Fund in Sudan: A Critical Review

Abstract

Introduction: National Health Insurance Fund (NHIF) is a semi-autonomous and national organization which is politically affiliated to Ministry of labor and social security and Woman and Child Affairs. NHIF is pointing to mitigate the risks of high cost of health services on both the government and population and securing the quality and accessibility of health services. Aim: this review is aiming to identify, and summarize the findings of relevant studies on the factors that affect NHIF in Sudan to be more accessible for decision makers to take a strategic decisions towards the universal health coverage. Methods: a qualitative exploratory analytical study. The study conducted on National Health Insurance Fund in Khartoum State. The study population was composed of the current literature that clarifying the research question. This study used SALSA framework: the Search, Appraisal, Synthesis, and Analysis framework which is a simple framework divides the review process into four main stages: (1) search (2) appraisal (3) synthesis and (4) analysis. Results: One of NHIF strengthen that it has a large coverage of population but it has low utilization of services by subscribers which considered as threat. Safeguarding health service users especially the poor against the implication of the market liberation policy embarked on by the Sudanese government is considered as opportunity to ensure the financial risk protection at NHIF but existence of The Federal Ministry of Finance as the major contributor in financing NHIF is a threat faces NHIF sustainability. Conclusion: This critical review shows that National Health Insurance Fund (NHIF) affected by many internal and external favorable and unfavorable factors. Those factors are: strengthens, weaknesses, opportunities, threats of NHIF which should be taken in consideration to achieve universal health coverage.