Africa-Press – Botswana. The Assistant Minister of Health, Mr Lawrence Ookeditse says the National Health Insurance (NHI) should be promulgated into policy and law.
Speaking at the launch of the NHI stakeholder engagement
at the Sir Ketumile Masire Teaching Hospital on Tuesday, Mr Ookeditse said the legal framework that established NHI needed to be created to give it a legal standing. In the first year as the stakeholder engagements continue, Minister Ookeditse said the NHI Policy Paper and NHI Bill, which included all the supporting legislation, Medical Aids Bill, Health Quality Bill, Health Professions Bill and others, should be completed.
He said reviewing relevant legislations and inter-governmental functions and fiscal framework that would be impacted by the implementation of NHI should also be achieved.
He also said clarification of the NHI benefits and services would be reviewed, preparation for the purchaser-provider split while review of medical schemes should define their future role.
Moreover, Mr Ookeditse said provision budget, restructuring of fund orders, registration of clients and registration of facilities would also be part of the process for the NHI. He said during the Winter Parliament, legislators needed to look into an enabling piece of legislation and relook into other pieces and policies to ensure proper alignment with the NHI.
“But it cuts across all other ministries, as we will look into digitisation, data protection and finance is also critical. We will be looking into getting funding from not just the consolidated fund but from the diversity as well as look into regulations that have to do with private medical facilities, medical aids and there will be more to be done during the Winter Parliament,” he said, adding that governing and legislating the standards of healthcare as well as accrediting public hospitals would also be done. He further said the introduction of the NHI would require reforms in the health system adding that initiatives such as re-engineering the primary health care (PHC), fix and clear referral pathways between public health care and community, strengthen PHC private facilities, treatment guidelines, define and develop health packages and norms and standards as well as tariffs that would be in place.
“The other important thing is the improvement in terms of quality in all our public facilities because they need to be plugged in to more or less the same level as private service providers,” said Mr Ookeditse. Giving insights on the NHI process, WHO Country Representative, Dr Fabian Ndenzako said the process was a journey, which needed many key elements to be successful.
Dr Ndenzako said the success of the NHI needed political will, which Botswana already had, supportive legal frameworks from a Bill to an Act of NHI, equitable essential care packages defined and in place, conducive health sector structure to support the implementation of the Board and administrative mechanism.
He also said NHI service schemes and costs needed to be in place and clear communication of NHI to citizens and stakeholders.
“We have extensive experiences in supporting many countries to design, implement and monitor the NHI schemes with teams of expertise at country, regional, headquarters and across countries,” said Dr Ndenzako, adding that WHO had worked with the Ministry of Health and other stakeholders to develop key documents. He said they assisted countries to develop the needed critical elements to ensure the efficiency of implementation of NHI. “The instruction, implementation and delivery of NHI comes with challenges with segment of population that need to maintain status quo, sometime legal battles. However, where political will exists, the NHI is implementable,” he said.
Dr Ndenzako further noted that the achievement and successful implementation of NHI by Botswana would be the country’s commitment to achieving the SDG 3.8.1 universal health coverage; ‘coverage of essential health services based on tracer interventions that include reproductive, maternal, new-born and child health, infectious diseases, non-communicable diseases and service capacity and access, among the general and the most disadvantaged population.’ “At WHO, we encourage countries to adopt and implement the scheme as it supports and provides achievement of universal health care,” Dr Ndenzako said.
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