The SP&PFM project in Zambia conducted training (March) for 11 officers of the National Health Insurance Management Authority on actuarial modelling results. In Zambia, the SP&PFM Programme has two objectives: (i) to improve the National Health Insurance Management Authority’s capacity for scheme performance monitoring, data collection for actuarial analysis and actuarial modelling and (ii) to determine the cost of expanding health insurance coverage to social cash transfer beneficiaries without requiring contributions or impacting the scheme’s financial sustainability.

 Since the country project’s launch in March 2022, the SP&PFM has conducted several capacity-building sessions for the National Health Insurance Management Authority staff. These sessions have enabled staff to conduct comprehensive scheme data audits and cleaning exercises that have led to improved data quality and easier monitoring of scheme performance. The cleaned data have allowed actuaries to define performance indicators and input requirements for the International Labour Organization’s (ILO) actuarial health tool, ILO/HEALTH.

 By February 2023, actuaries had successfully formulated costing assumptions and conducted sensitivity analyses using the ‘ILO/HEALTH’ tool. During the March training session, preliminary results were presented to the National Health Insurance Management Authority officials responsible for day-to-day scheme management, such as finance, investments, health insurance services, information technology, quality control and accreditation, and research and planning. The Authority’s staff were also trained on how to input data and define assumptions jointly with the actuaries, allowing them to validate baseline assumptions based on their practical experience.

 The staff appreciated the approach taken by the actuaries because it ensured ownership of the actuarial outcomes, and the following comments from three participating officers reflected this.

 “The training session was very interactive and provided all the different perspectives on which the model is built. The session provided a hands-on training on the platform.”

 “The results are a reasonable reflection of the future ahead. The session was highly consultative, and feedback considered. This allowed for the ownership of the process and the results.”

 “This training session was very comprehensive, transparent and interactive. Having the facilitators open to each participant’s view was very great.”


As a result of the useful training, SP&PFM  recommended that the National Health Insurance Management Authority conduct scheme data reviews annually to update the data using the ‘ILO/HEALTH’ tool. This will enable the agency to improve its performance monitoring and actuarial costing capacity and thus drive sustainable extension of coverage.

 Overall, the training has strengthened the agency’s capacity for actuarial modelling and scheme performance monitoring, thereby enabling independent future analyses. This will enable the National Health Insurance Management Authority to provide better health insurance coverage to social cash transfer beneficiaries and to improve the scheme’s overall financial sustainability.

 Learn more about SP&PFM in Zambia