Community health insurance in Uganda: status, obstacles and prospects

The book provides an invaluable understanding of Community health insurance (CHI) in Uganda. It is an investigation into the obstacles and prospects for CHI schemes. It addresses the: (1) demand and supply side factors to explain the low levels in CHI schemes; (2) the perceptions of CHI held by those enrolled and those not enrolled (3) knowledge, understanding and perceptions of the relevance of CHI and (4) formulates evidence-based policy recommendations for the Ugandan health sector. The reasons for not joining CHI schemes specific to the Ugandan context are: (1) inappropriate entrance rules; (2) unattractive benefit packages; and (3) lack of involvement of first- line health units, which all reduce the attractiveness of the CHI schemes. The policy options proposed are: (1) CHI implementation continues to be restricted to the private, not-for-profit sub-sector, (2) the health sector implements CHI in the public sector, which implicitly means abandoning the policy of the abolition of user fees and reintroducing user charges in the public sector and (3) CHI temporarily fills the gaps in public and private-not-for-profit local health care delivery as is currently being done.