Africa's health insurance boost
In Africa, where disease can strike unprepared communities and compromise their well-being considerably, health insurance can represent the difference between life and death. The EU-funded project Shield has investigated health system inequities and inequalities in these countries. The project studied the healthcare systems in three different parts of Africa, namely Ghana, South Africa and Tanzania, examining healthcare burdens and benefits among socioeconomic groups. It identified current and future options such as pre-payment mechanisms for funding healthcare and looked at related policies. All three countries exhibited very different health insurance systems and in particular alternative health insurance plans. Examples of the latter are the community-based mutual health organisations (MHOs) in Ghana and the pre-payment schemes in Tanzania, including the country's community health fund (CHF) approach. On the other hand, South Africa has no community-based pre-payment schemes but substantial private voluntary insurance for its workers, implying that the three countries can learn from each others' experiences. In addition, the project examined possibilities of implementing mandatory health insurance, a concept which is in varying stages in each of the three countries. It also looked at the very high out-of-pocket payments, the link between socioeconomic groups and healthcare funding, the burden on tax systems, and general health insurance contributions. Shield carefully investigated the distribution of percentage share of health service benefits and healthcare needs across socioeconomic groups, exposing the issues lying beyond the control of the health sector. It highlighted barriers to healthcare benefits that affected poorer and rural communities, then outlined country-specific models for future healthcare financing reform for each country. If these EU-led scenarios are exploited and the barriers overcome, healthcare in the three countries would improve, offering a strong model of success for the rest of the continent.
