Health Insurance towards Universal Health care
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Health Insurance towards Universal Health care

Last week His Excellency the President, Dr. Julius Maada Bio launched the first insurance scheme for Health workers. Under the Group Life Insurance Scheme, all eleven thousand frontline health workers who are engaged in the fight against COVID-19 will benefit. This is very good news!

During disease outbreaks, health workers are  at particularly high risk  of infection which sometimes lead to their loss of lives. We recall that during the Ebola outbreak, Liberia, Sierra Leone and Guinea lost as many as 500 front line workers.

In Sierra Leone, we lost some of our highly skilled health workers. The case of health workers makes for special mention. While they are duty bound to attend to all cases, and at all times, they so often only realise the condition they have attended to when it is too late, and they have been overly exposed. These health workers have families! They are our wives, our husbands,  our fathers, our mothers, grandparents etc etc. Because of their relative better social status, they are often our benefactors in several respects. So, the loss of the life of a health worker during an outbreak can be catastrophic to his or her family.

Through our outbreaks with Ebola. Lass fever and now COVID-19, our nation has become indebted to our very hardworking front-line workers, many of whom work at very difficult conditions.  It is within such context that the government's institution of a health insurance scheme for frontline health workers is positive and forward-looking! It is symbolic of a nation's recognition and gratitude.

This move by the government represents entry into a new discussion and possibly a new era. That new discussion relates to how we can use health insurance to achieve our ultimate goal of universal health coverage. A health insurance scheme is one in which in the absence of disease, we each set aside a minimum contribution either monthly or yearly to an investment scheme that ensure that when we fall ill, we will not be required to pay money at point of care, and yet be assured of good quality health care.

So many of our people either stay away from accessing health services or do so when their condition is severe and complicated. We can only shudder to consider how many people have lost their lives because they cannot afford upfront payment at health facilities. Health insurance is an accompaniment of a modern society and Sierra Leone cannot be left out. Countries like Kenya, Tanzania, Rwanda and Ghana have some forms of health insurance, what that means is that we can draw on their lessons to fashion out a scheme that works for us.

Our society is largely informal and quite heterogenous, so it may well be possible that we will have different schemes or different programs for different sectors of our economy and possible for different districts. But whatever form it takes if it satisfies the goal of preventing upfront payment and insuring universal health care we would have achieved our aim. We should not shy away from being innovative and getting for ourselves a scheme that works for us.

Countries have used different approaches to expand coverage in quality health services for vulnerable groups.  Health Insurance is attracting greater attention in low and middle-income countries as a means of improving access to health care and protecting citizens from impoverishment. The World Health Organisation (WHO) considers health insurance as a means to achieving Universal Health Care.

The arrangement currently put in place for front line workers should remind us to pick up the agenda for an effective national health insurance scheme. Our technocrats should feel challenged to come up with workable modalities for a sustainable scheme. 

The time has come for our health researchers to fashion out and pilot out the options that are available to us and inform us better on how we can implement a national health insurance scheme. This should be done within the shortest possible time.

Kudos President Bio! The insurance scheme for front line workers is a great move.  Apart from fulfilling its primary objective it is causing us to think seriously about how to achieve universal health care for all Sierra Leoneans. This is a charge for our technocrats! And I am confident that our technocrats are up to the task and capable of rising to this challenge.

Lonta ka da Bai! For love of Mama Sierra Leone.

Yours sincerely

Yeama Sarah Thompson


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