February 20, 2018 By Alusine Sesay
President Ernest Bai Koroma on Friday, 16 February launched the Sierra Leone Social Health Insurance Scheme(SLeSHI) – a scheme meant to provide universal healthcare coverage for all and sundry across the country.
While launching the scheme at the Bintumani Conference Centre in Freetown, President Koroma said it was a transformation in Sierra Leone’s health sector from where it used to be to the present, reflecting on the launch of the free healthcare initiative in 2010.
He said financing in the health sector was minimal, while existing healthcare facilities were in a deplorable state.
He noted that since it is the responsibility of government to provide better healthcare services for its citizens, “we decided to address the healthcare issues to enable sustenaible developemnt. We took the bold initiative to provide free healthcare for the most vulnerable groups of people – pregnant women, lactating mothers and children under five.”
“We are trying to build a very robust health system. We cannot continue to rely on donors for health financing, hence the establishment of SLeSHI. The scheme would take the country to a next level and would increase healthcare coverage,” he said.
Speaking during the launch, Coordinator of SLeSHI, Dr. Joseph Kamara underscored that expenditure on healthcare continues to be on an upward trajectory to the extent of placing many people into poverty, and that finacing healthcare continues to be a critical challenge globally, moreso in devloping countries like Sierra Leone.
He said the current healthcare financing system in sierra leone was not sustainable and that the country has one of the highest out-of-pocket expenditures on health.
“In 2014 alone people spent about 2.9 trillion Leones out of their pocket for healthcare.The current healthcare financing system is also a medium of poverty as most households spend very high percent of their income on healthcare. The informal sector and poor households finace their out-of-pocket health expenses -in most cases by borrowing or support from relatives or even selling their assests,” he explained.
Dr. Kamara asserted that there was over reliance on external financing in the health sector and that in 2014 alone, development partners contributed about 2.3 billion Leones to the Sierra Leone health sector.
“The above mentioned problems have shown that there is a dire need for a reliable and sustainable domestice finacing mechanism. Health insurance has been thought as the prefered financing option to extend access to healthcare in countries where out-of-pocket health expenditures are high,” he said.
He said the purpose of the new health insurance scheme was to increase access and use by making healthcare services affordable, improve healthcare status through increase access and use and to mitigate the financial consequencies of health financining across all the board.
The SLeSHI Coordinator described the scheme as a mechaism that would pool resourecs and risk together for effective and efficient distribution of healthcare service across the country, adding that it was bulit on the social insurance principles of solidarity, equity, efficiency, quality, accessibility, affordability and effectiveness.
He continued that the key objectives of the scheme would be to increase financial protection of the poblic by promoting pre-payment for healthcare services, mobilise financial resources in an equilitable manner and to improve effectiveness, efficiency, accountability and quality of care in the delivery of healthcare services across the country.
He said the the scheme would help reduce out-of-pocket expenditures at the time of health service need, pool and allocate funds in an equitable manner, mobilise local community groups to increase participation of the general public in the scheme, implement various interventions and activities aimed at improving healthcare across the country .
He disclosed that the scheme would cover all Sierra Leoneans and people resident in the country, noting that some people would be exempt from contributing but would benefit from the scheme.
He said people in the informal sector would be contributing Le15,000 (fifteen thousand Leones) monthly, while those in the formal sector would be contributing six percent of their monthly salaries, adding that children below age twelve, the aged and persons with disablities would be exempt from contributing to the scheme, although they are beneficiaries of the service.
He maintained the scheme would increase access to healthcare, reduce out- of- pocket expenditures, imrpove the quality of healthcare delivery and that it would be sustainable.
Dr. Kamara stated that the scheme would help boost the economy of the country by providing quality healthcare, create jobs for Sierra Leoneans and support private sector growth.
He thanked President Kororma for what he referred to as his unwavering support to the success of the scheme, while also recognising the contributions of the coordinating and technical teams, and the Ministries of Labour and Health for their support in ensuring that the process became a success.
Minister of Labour and Social Security, Dr.Mathew Teambo, noted that the ceremony marked an important milestone in the history of the country, adding that access to quality healthcare has been a serious challenge in thye country which the president was piosed to address.
Dr. Teambo said SLeSHI was expected to increase access to affordable and quality healthcare service and encourage savings, thereby subsequently helping in the area of poverty reduction. He said the scheme would considerably help in enhancing life expectancy in the country.
Deputy Minister of Helath I, Madina Rahman, noted that the scheme was being commissioned at a very important time in the country and that it was in line with the health target of the Suistainable Development Goals.
Representatives of the Council of Paramount Chiefs, Association of Employers, the informal sector and Labour Congress all wellcomed the initiative, thus promising to be part of its implementation.