Zambia

Evaluation of the National Health Insurance Scheme (NHIS)

A Real-Time NHIS Indicator Reporting Dashboard was developed, providing daily reports to the management team on the performance of the scheme on key indicators thus informing decision making processes.

21 officials of the National Health Insurance Management Authority and the Ministry of Labour and Social Security participated in capacity building activities 

Activities focused on introducing actuarial valuation principles, introducing the ILO/HEALTH MODEL and identifying required data for the actuarial valuation.

Costing exercises to expand social health insurance coverage to non-contributory members carried out

Estimation of costs provided the basis for developing financing options to ensure the scheme’s sustainability while extending NHIS coverage.

The project “Accelerating the extension of the Zambia National Health Insurance scheme to the poor and vulnerable” supported the application of actuarial costing models to contribute towards the implementation of the National strategy on the extension of social security coverage to the informal economy. The overall project objective was to pave the way for the extension of health insurance coverage to the poor and vulnerable, as per the Zambia National Health Insurance Act No. 2 of 2018.

The initiative seeked to strengthen the National Health Insurance Management Authority’s (NHIMA) capacities in scheme performance monitoring, data collection and actuarial modelling. The project provided technical support to quantify the cost of extending health insurance benefits to non-contributing poor and vulnerable participants, and its impact on the overall financial sustainability of the scheme. This data will serve to develop evidence-based recommendations to Government, for expanding social health coverage in line with the Zambian Government’s goal of attaining Universal Health Coverage (UHC).  

Project implementation period: March 2022 to March 2023.

Key results achieved in 2022

  • The Project promoted the capacity building of 21 officials from the National Health Insurance Management Authority (NHIMA) and the Ministry of Labour and Social Security (MLSS) through: (i)introducing actuarial valuation principles, ii) introducing the ILO/HEALTH model, and iii) identifying requisite input data to be able to undertake the actuarial valuation. Data cleaning sessions were also held to ensure scheme data was appropriate for the ILO/HEALTH model while enhancing NHIMA’s and MLSS’ data management capacities and skills.

  • The Project lead the data cleaning exercise carried out by NHIMA and MLSS officials, with follow-up training on ILO/HEALTH calibration applications to be held from 13 to 17 March 2023.

  • NHIMA, working with the Ministry of Community Development and Social Services (MCDSS) successfully managed to obtain the relevant Social Cash Transfer beneficiary data which was assessed by the actuarial team and declared fit for purpose in the estimation of the liability of coverage extension to the SCT beneficiaries.

  • Based on the Communications and visibility plan validated by the EU delegation, the project successfully conducted a panel discussion on one of Zambia’s biggest radio stations as well as published an article in the local newspaper to sensitize the public on the objectives of the project. The project also managed to make a presentation to a group of international donors working in Social Protection in Zambia where project objectives were shared. The presentation successfully ignited debate on various issues including how to donors can support resource mobilisation efforts and lobby the Government to prioritise the financial sustainability of the scheme.

Events

Partners

The project is implemented by the International Labour Organization in partnership with the National Health Insurance Management Authority, the Ministries of Labour & Social Security, Community Development and Social Welfare, Health, and Finance. The project similarly engages with the Zambia Statistics Agency and the relevant Technical Working Group stakeholders of the National strategy on the extension of social security coverage to the informal economy.

Contacts

Felix Mwenge, ILO Co-Lusaka, National Project Coordinator – Social Protection mwenge@iloguest.org

Andrew Allieu, ILO DWT Pretoria, Sr Specialist, Social Protection, allieu@ilo.org

Kagisanyo Kelobang, ILO HQ SOCPRO Social Protection Analyst, kelobang@ilo.org   


Video: Minister of Labour and Social Security launches NHIMA’s Strategic Plan 2023-26: Social Health Financing for Universal Health Coverage (January 2023)

Data cleaning workshops for NHIMA and MLSS officials (October 2022).

Data cleaning workshops for NHIMA and MLSS officials (October 2022).

Brochure promoting the project “Accelerating the extension of the Zambia National Health Insurance scheme to the poor and vulnerable”, supported by SP&PFM.

Lauching of the SP&PFM project in Zambia on 22nd June 2022.

Woman at her fruit stall at a market in the town of Lumwana, Zambia (2015)

Achieving Universal Health Coverage is a key strategic goal for the government of Zambia. In this pursuit, the National Health Insurance Management Authority (NHIMA) is extending health insurance coverage to the poor and the vulnerable, which requires robust estimates of the cost and fiscal implications to the government and the Scheme. The project is supporting NHIMA to build actuarial costing capacity to estimate prospective liabilities to the Scheme. This will help NHIMA and the government to devise strategic policies for sustaining the Scheme’ solvency while leaving no one behind.

Herryman Moono

Director, Research & Planning, National Health Insurance Management Authority (NHIMA)

Woman with her baby working in her little food shop in Kambwise, Zambia (2015)