Journal of Preventive Medicine and Public Health

Perspective

The Paradox of the Ugandan Health Insurance System: Challenges and Opportunities for Health Reform: Emmanuel Otieno, Josephine Namyalo; J Prev Med Public Health. 2024;57(1):91-94. Published online December 30, 2023; DOI: https://doi.org/10.3961/jpmph.23.110

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For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.

Summary

Key Message
For the Ugandans, nearly the last four decades have been years of hope, conflict, and resilience in a myriad of contexts for healthcare reform. Health insurance system has no legal framework and provides benefits not to the entire national population. The 2019 National Health Insurance scheme Bill was passed in 2021. If the President of Uganda assents to the National Health Insurance Bill, it will be a compelling policy in health and health for all policies. But this Bill has several drawbacks. In this perspective, we aimed to provide intricacies and mix of challenges and opportunities for the health sector.

Citations

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Systematic Review

Challenges to Achieving Universal Health Coverage Throughout the World: A Systematic Review: Alireza Darrudi, Mohammad Hossein Ketabchi Khoonsari, Maryam Tajvar; J Prev Med Public Health. 2022;55(2):125-133. Published online March 8, 2022; DOI: https://doi.org/10.3961/jpmph.21.542

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Abstract PDF Supplementary Material

Objectives
No systematic review has explored the challenges related to worldwide universal health coverage (UHC). This study reviewed challenges on the road to UHC.
Methods
A systematic electronic search of all studies that identified the challenges of worldwide UHC was conducted, without any restrictions related to the publication date or language. A hand search and a bibliographic search were also conducted to identify which texts to include in this study. These sources and citations yielded a total of 2500 articles, only 26 of which met the inclusion criteria. Relevant data from these papers were extracted, summarized, grouped, and reported in tables.
Results
Of the 26 included studies, 7 (27%) were reviews, 6 (23%) were reports, and 13 (50%) had another type of study design. The publication dates of the included studies ranged from 2011 to 2020. Nine studies (35%) were published in 2019. Using the World Health Organization conceptual model, data on all of the challenges related to UHC in terms of the 4 functions of health systems (stewardship, creating resource, financing, and delivering services) were extracted from the included studies and reported.
Conclusions
This study provides a straightforward summary of previous studies that explored the challenges related to UHC and conducted an in-depth analysis of viable solutions.

Summary

Citations

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COVID-19: Perspective

New Obligations of Health Insurance Review and Assessment Service: Taking Full-fledged Action Against the COVID-19 Pandemic: Seung Mi Yoo, Seol Hee Chung, Won Mo Jang, Kyoung Chang Kim, Jin Yong Lee, Sun Min Kim; J Prev Med Public Health. 2021;54(1):17-21. Published online January 26, 2021; DOI: https://doi.org/10.3961/jpmph.20.594

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Abstract Summary PDF

In 2020, the coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruptions to global health systems. The Korea has taken full-fledged actions against this novel infectious disease, swiftly implementing a testing-tracing-treatment strategy. New obligations have therefore been given to the Health Insurance Review and Assessment Service (HIRA) to devote the utmost effort towards tackling this global health crisis. Thanks to the universal national health insurance and state-of-the-art information communications technology (ICT) of the Korea, HIRA has conducted far-reaching countermeasures to detect and treat cases early, prevent the spread of COVID-19, respond quickly to surging demand for the healthcare services, and translate evidence into policy. Three main factors have enabled HIRA to undertake pandemic control preemptively and systematically: nationwide data aggregated from all healthcare providers and patients, pre-existing ICT network systems, and real-time data exchanges. HIRA has maximized the use of data and pre-existing network systems to conduct rapid and responsive measures in a centralized way, both of which have been the most critical tactics and strategies used by the Korean healthcare system. In the face of new obligations, our promise is to strive for a more responsive and resilient health system during this prolonged crisis.

Summary

Korean summary
건강보험심사평가원은 전 국민과 전체 요양기관의 축적된 정보, 전체 요양기관과 연결된 네트워크, 실시간 데이터 공유를 통해 이번 코로나19 위기 대응에 기여했다. 건강보험심사평가원은 1) 진단검사∙약제 등재, 2) 요양기관 내 고위험군 감지, 3) 마스크 중복구매 방지 시스템 구축, 4) 주요 보건의료자원 가동현황 모니터링 시스템 구축, 5) 환자관리 정보시스템 구축 및 익명화된 환자 데이터 공개로 국제협력연구 촉진의 다섯 가지 전략을 성공적으로 수행했다. 건강보험심사평가원은 현재의 보건위기 상황을 극복하고, 코로나19 시대 이후로도 새롭게 주어진 위기대응의 역할과 소명을 다할 것이다.

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