Universal Health Coverage (UHC) is the possibility for all individuals to access quality healthcare at an affordable cost and prevent financial hardships due to expenditure on healthcare services. Currently, a lot of African countries have introduced Universal Health Insurance (UHI) programs to promote UHC. These programs cover a portion or all risks of incurring medical expenses.
Health Insurance (HI) reduces an individual’s financial burden of purchasing healthcare services by pooling funds and sharing the risk of forecasted unexpected health events. They do this by establishing or integrating risk-sharing mechanisms. These mechanisms are needed in Sub-Saharan Africa because most countries in the region do not dedicate sufficient resources to health care.
Indeed, health insurance is the lifeline for UHC in Sub-Saharan Africa and globally. Health insurance schemes are rapidly emerging and expanding in Sub-Saharan Africa. Although health insurance coverage rates remain low in some African countries, Nigeria’s out-of-pocket payments to healthcare providers dropped by 7.14 % (from 75.9 % in 2018 to 70.5 % in 2019).
So far, 20 African countries (including Ghana, Kenya, Nigeria, Tanzania, and Uganda) have undertaken surveys to measure the price, availability, and affordability of healthcare with support from the World Health Organisation (WHO) and Health Action International (HAI). These surveys identified barriers such as delays in settling claims, report-fraud, administrative issues, cost-sharing burden, and limitations to the medical benefit as the reason for low coverage and adoption of health insurance schemes. To achieve a maximum effect of health insurance and universal health coverage in Africa, an effective monitoring system is needed to enable HI agencies track the impact of policies and programs.
At eHealth4everyone, we developed a platform called OpenHISA (Open Health Insurance Systems and Analytics) that can facilitate this. OpenHISA captures, collates and aggregates data. It also enables the analysis of various trends and insight, and it can be used to address the challenge of low coverage and utilization of healthcare services.
The OpenHISA platform also prevents the barriers stated above. Currently, this platform enables claims processing and management in health facilities. This platform collects service-level data at health facilities, stores it, and enables vetting, analysis, and utilization of claims data. This feature aids facility reviews, and also ensures delivery of the highest quality of service in health facilities. The OpenHISA platform mitigates cash-flow delays from the source to service delivery points.
OpenHISA can be deployed to your facility today. To set-up or request for a demo, send an email to firstname.lastname@example.org or call 09021720570.