SHU proposed to the Health Committee of Parliament her position on the proposed National Health Insurance scheme. The key issues were;
(1) The National Health Insurance Scheme (NHIS) to charge premiums based on peoples’ income levels promote cross sub-subsidization and equity in accessing health care services.
(2) The scheme to have a single pool where all premiums collected shall be deposited and managed.
(3) Incorporating Community Health Insurance (CHI) schemes into the NHIS to tap into their existing active structures to create awareness about health insurance, share feedback with families, collect premiums from informal sector families and transfer the money to the single pool.
(4) All health care service providers to be contracted by the scheme to undergo a uniform and thorough accreditation process.
(5) The NHIS scheme to be managed by an independent body bearing at least one representative of the CHI promoters.
Strong institution
Since its establishment in 2002, SHU has grown from a small community-based organization to a national Non-Government Organization (NGO) mandated to operate countrywide. We have well-established governance and management structures and systems that operate under clearly documented policies.
Other Achievements
Recognition as a leader in Community Health Financing
We are the leaders in promoting Community Health Financing (CHF) in Uganda. The scale of our operations has expanded over the years to reach 11 districts. By the end of 2023, we had supported over 111 running CHF sub-schemes covering 27,037 beneficiaries and network of 36 Healthcare Providers. We have cultivated a culture of saving for healthcare among the communities we work with. We are recognized as a voice for the vulnerable families advocating for the introduction of a fair National Health Insurance Scheme that caters for the informal sector families. We have held 7 national CHF conferences and raised awareness about CHF and advocated for the introduction of a fair National Health Insurance Scheme. With our direct support, Luwero district council passed a resolution in December 2023 to implement a district wide CHI scheme which will work as a pilot for other districts to scale up CHI and also for the country to roll out the National Health Insurance Scheme.
CHF schemes
We supported the parish-based CHF sub-schemes to federate into schemes at regional level as a strategy to build their sustainability without external support. The schemes are directly responsible for contracting health care providers, purchasing healthcare, issuing identification cards, and managing scheme funds. They are registered as Community Based Organizations in their districts of operation and have governance structures composed of scheme members. The scheme are five: Munno Mu Bulwadde Union of Schemes Organisation (MBUSO) covering Luwero, Nakaseke and Nakasongola districts; Western Ankole Tweragurize Schemes’ Association (WATSA) operating in Bushenyi, Sheema and Mitooma districts; Munno Mu Bulwadde Schemes’ Cooperation Mechanism (MSCOM) in Mityana and Kassanda districts; Central Region Urban Munno Mu Bulwadde Schemes-Luwero (CRUMBS-L) that targets organized groups in Luwero, Nakaseke, Nakasongola and Masaka districts; and Busoga Region Association of Tweidhandhabe Schemes (BURATS) covering Iganga, Bugweri and Mayuge districts. Federating individual sub-schemes increased healthcare benefits and portability of services for scheme members due to increased pooling levels. The schemes are able to pay 100% of all the medical bills of all their members in time. The schemes have also been supported to establish a functional leadership structure from village level to the regional level with clear policies and procedures that guide the management of these schemes.
Our partnerships
We have built strong partnerships at various levels which enable us to reach our target communities and serve them well. We have a Memorandum of Understanding (MoU) with all the districts where we operate and also the 36 health care facilities that serve the schemes country-wide. We belong to networks of civil society organizations at national level and in districts. We are members of the Uganda National NGO Forum (UNNGOF) and Federation of Uganda Employers (FUE). SHU represents all the CHI promoters in Uganda on the task-force designing the National Health Insurance Scheme (NHIS). We are working with numerous national level organizations in advocating for a fair NHIS. We have partnerships with Micro-Finance Institutions which support CHF scheme members to access affordable loans to start and boost their income generating activities.