In the Republic of Zambia the mortality rate for children under-five dropped from 190.7 per 1000 live births in 1992 to 64 per 1000 live births in 2015. This reduction in child mortality has been achieved throughout the implementation of Zambia’s Universal Health Insurance scheme, which merged and replaced three compulsory schemes for the formal sector, informal sector and local populations in order to broaden the extent of coverage.
Zambia’s Universal Health Insurance is a contributory scheme, which provides coverage to those employed in the central government, the local government, State owned enterprises and the formal private sector. Each contributor is eligible to register six beneficiaries and pays a flat fee, subsidized by the government, in order to access health care services. Claimants are entitled to a comprehensive package of outpatient and inpatient care including medical consultations, dental care, medical imaging, laboratory tests and surgery expenses. Maternity benefits include medical and drug costs, tests, hospitalization for pregnancy, delivery, and its effects up to week eight. Curative care benefits include consultations, nursing care, drugs, laboratory testing, chronic diseases, malnutrition and nutrition rehabilitation. The scheme currently covers approximately 22 per cent of the total population and is expected to cover 35 per cent of the total population by 2023.
The legal framework for health care in Zambia is currently being strengthened through the drafting of a new constitution, in which the Government has pledged to uphold “the right to the highest attainable standard of health, which includes the right to health care services and reproductive health”. It further guarantees “the right to social security and protection” of all citizens. Thus, while the Universal Health Insurance scheme is a step toward creating a social protection floor, the framework for further strengthening coverage is currently being designed, displaying political will for more robust health coverage in Zambia.
Further Reading:
Health Policy Project from the Health Financing Page May 2016 with contributions from USAid. Accessed from https://www.healthpolicyproject.com/pubs/7887/Zambia_HFP.pdf on December 2016.