By Omar Bah
Health Minister Dr Ahmadou Lamin Samateh has told National Assembly members that the government’s conceived Social Health Insurance Scheme, which The Standard will from today call the Barrow Care, is very progressive and has the potential to address Gambia’s health challenges.
“The introduction of the scheme was conceived by the government to ensure that out-of-pocket expenditure on health which currently stands at 24.55% is eliminated or reduced through a robust financial risk protection mechanism,” Minister Samateh said at a meeting organised to introduce the scheme to lawmakers last Friday.
The scheme is designed to ensure all individuals have access to effective public health and personal health care, ensure choice of cost-effective intervention, and set appropriate financial incentives for providers and provide the population with highest quality of health services.
The country’s public sector currently dominates healthcare delivery in The Gambia with the private facilitates making up only 10% of total health facilitates while 74% of the country’s health funding is coming from donors.
“As you may be aware, health financing is one of the six building blocks of a health system, and social health insurance is key to making progress toward achieving Universal Health Coverage (UHC), yet its implementation continues to be a major challenge in many developing countries, including The Gambia,” he said.
But the scheme, Samateh added, will undoubtedly increase access to quality health care services and by-extension improve the overall health system for better service delivery.
“The Scheme is a combination of both compulsory and voluntary contributory health insurance schemes targeted at formal sector workers as well as informal sector workers. It is also about social justice and equity. It is simply about the way countries share their money for health, who gets what. It is not about sharing budgets of health, no,” he said.
According to the National Health Accounts (2017) survey, government health expenditure as a share of Gross Domestic Product (GDP) is at 1.66%.
This, Minister Samateh stressed, falls below the WHO recommendation that for a country to move towards achieving UHC, it must spend at least 5% of its GDP on health. Similarly, out-of-pocket expenditure as a percentage of total health expenditure continue to rise and it currently stands at 24.55%.
“This suggests that Gambians are enduring financial catastrophe in accessing health care services. This shows that there has been limited progress in addressing the health financing challenge Gambia faces, and the introduction of Social Health Insurance Scheme will no doubt address this huge challenge of our health care financing landscape,” he added.
The Minister of Finance, Mambury Njie said the introduction of the scheme clearly demonstrates that the government is on track to transform its health care financing landscape.
“Unlike using government revenue to fund healthcare services provided by the public healthcare system, social health insurance can be designed to provide some choice of healthcare services in either the public or the private sector through purchase and subsidisation of services,” he said.
Pregnant women, children and persons with disability will be exempted from the Insurance Scheme.
Meanwhile, a Gambian resident who is not a member of a private health insurance scheme, shall be a member of the scheme within two years of the coming into force of the bill and except as otherwise provided for in the Act, every resident of The Gambia will pay an amount to be determined by the scheme.