March 15, 2017 By Ibrahim Tarawallie
Even though healthcare is a right for every citizen, Sierra Leone has been over reliant on external funding to help in the improvement of its health sector, which has been in shambles for decades.
The proposed introduction of Sierra Leone Social Health Insurance Scheme by the National Social Security and Insurance Trust (NASSIT) in collaboration with the Ministries of Labour and Social Security and Health and Sanitation is seen as timely, because of the dire need for a reliable and sustainable domestic financing to the sector.
At the Raddison Blu Mammy Yoko Hotel in Freetown yesterday, NASSIT launched the Inception Actuarial Valuation report, which measures the financial soundness of the proposed SLeSHI scheme.
According to the Coordinator of the SLeSHI Scheme, Dr. Joseph Kamara, the current healthcare financing system in the country was not sustainable as it is plagued with high Out Of Pocket (OOP) health expenditure, thus making many people not to access healthcare at the time of need, while serving as a conduit for majority of the poverty cases as most households spent a very high percentage of their income on health.
Because expenditure on health is amongst the highest in a household, Dr. Kamara noted that a health insurance scheme of such nature would not only guarantee good health but would also leap many people out of the poverty line through the reduction in Out of Pocket health expenditure.
“Health Insurance has emerged as the Preferred Financing Option to extend Access to Health Care in countries where Out of Pocket health expenditures are high,” he said.
He maintained that Social Health Insurance as a ‘benefit’ tax, has the potential of having more willingness to pay, remove financing from annual general government appropriations process and generally provides covered population with access to a broad package of services.
He expressed optimism that when introduced, the scheme would help increase access to primary healthcare facilities across the country, harmonizes funding into the health system and changes payment basis from inputs to outputs, with providers expected to meet agreed and contractually committed goals before payment is disbursed.
With regards source of funding and target population, the SLeSHI Coordinator said those from the informal sector would have to pay Le15, 000 per month, while 6% of social security contributions would be for those in the formal sector, adding that all Sierra Leoneans and residents within the country would be targeted.
“Healthcare services will cover 95% of all health problems reported in all Sierra Leonean Primary Health Care (PHC) facilities. Contributions will be paid directly to SLeSHI accounts and funds will be collected and manage by us,” Dr. Kamara said.
He added that children under twelve, pregnant women, lactating mothers, mentally retarded, pensioners (65+) and the Indigents will be exempted from contributing to the scheme.
Dr. Samuel S.A. Kargbo from the Ministry of Health and Sanitation welcomed the report and the proposed introduction of the scheme.
He revealed that they have already commenced assessment of healthcare facilities across the country to aid the introduction of the scheme, and that criteria would now be set for the opening of new health facilities.
Chief of Staff at State House, Saidu Conton Sesay said: “From the presentation, a lot of work, research and consultations have been done. Government is committed to continue to improve the quality of life and living standard of the people. The scheme is not an isolated project.”
While launching the report, Labour Minister, Dr. Mathew Teambo stated that it captures all the issues and the various sources of funding for the scheme.