Ethiopia: Health Insurance Schemes to Commence in Addis

Feb 21, 2018 | The Ethiopian Herald - All Africa

The Ethiopian Health Insurance Agency has finalized preparation to implement health insurance schemes in Addis Ababa for low-income groups.

The Ethiopian Health Insurance Agency (EHIA) said it has finalized preparation to implement health insurance schemes in Addis Ababa in the view to ensure low-income groups access to modern health service delivery. Cognizant the role the insurance schemes have played in improving rural communities' health delivery, the Agency is working to execute the schemes in Addis Ababa, EHIA Communication Director, Assefa Yirgalem told The Ethiopian Herald.

The Director indicated that the service has already started in Addis Ababa's nine woredas at a pilot level and the new move aims to expand the schemes availability to in other parts of the city. According to Assefa, residents of the Capital would make formal agreements and pay a premium fee, on an annual or monthly basis to EHIA thereby their expense for approved health services covered by the Agency.

The Agency has been finalized preparation to implement two health insurance schemes namely Community Based Health Insurance (CBHI) and Social Health Insurance (SHI). CBHI is a voluntary insurance scheme aimed at primarily benefiting the 80-85 percent of the Ethiopian population engaged in informal sector (crop and pastoral farming) whilst SHI is a mandatory program for formal sector employees.

The Director said: "Beneficiaries of both health insurance schemes are entitled to get health care services including inpatients, delivery service, surgery, laboratory checkups as well as imaging services such as Magnetic Resonance Imagining (MRI), CT Scan, among others." Assefa noted that people in the CBHI are provided with specified benefits regardless of their contribution whilst SHI service is financed by payroll or pension contribution and the recipients are entitled to the delivery based on their contribution.

Apart from improving access of low-income citizens and enabling them to get modern health service without the risk of being improvised, the schemes would have a pivotal role in enhancing public's culture of helping one another, the Director noted. Assefa said that the Agency is closely working with pertinent stakeholders to address financial and logistical shortcomings as well as skilled manpower gaps witnessed in the implemented health schemes. Ethiopia commenced Community Based Health Insurance service at pilot level in 2010 in 13 woredas of Tigray, Amhara, Oromia and SNNP states and currently over 16 million people residing in the 384 woredas of the aforementioned states are benefiting from the scheme.


Source: All Africa