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Health care services delivery program

We advocate for the increase in the national health budget and for delivery of quality health care services at partner health facilities; support both the accredited health care providers and the networks of CHI schemes to sign service contracts; and facilitate the schemes to pay for all services consumed.

What we do to facilitate the schemes to pay for all services consumed

  1. We support schemes to develop products and charge the appropriate premiums
  2. We support schemes and health care providers with appropriate technology and tools to identify beneficiaries and bill the schemes.
  3. We support the networks to provide up-to-date information to health care providers about benefits and member information.
  4. We build systems and capacity of scheme leaders to receive, verify and recommend to networks to pay medical bills to health care providers.

What we do to advocate for the increase in the national health budget

  1. We participate in activities of the Civil Society Budget Advocacy Group aimed at influencing policy makers to allocate more financial and other resources to the health sector.
  2. We engage policy makers on health sector budget allocation through sharing evidence based information on gaps in health services delivery.

What we do to improve the quality of healthcare services.

  1. We train health care provider staff in patient centred care and procedures of coverage of CHI scheme members.
  2. We establish feedback mechanisms between health care providers and CHI schemes
  3. We advocate for representation of CHI scheme members on health facility management committees
  4. We work with district health authorities to conduct technical support supervision of health care facilities
  5. We empower communities to participate in advocacy for increased budget allocation to the health sector.

What we do to support both the accredited health care providers and the networks of CHI schemes to sign service contracts

  1. We accredit health care facilities and provide the list to the networks for possible contracting
  2. We support schemes to prepare contracts.
  3. We prepare health care providers and scheme members separately to enter into formal contracts.
  4. We facilitate negotiations and witness the signing of service contracts.
  5. We monitor implementation of service contracts by both parties and cause action for improvement.
  6. We organize annual meetings between health care providers, scheme members and network leaders to share experiences on how to improve the quality of services.

Health care facilities contracted by schemes

Health care services delivery program