The day began as usual with Samantha seated on a motorcycle taxi, commonly referred to as a boda-boda, rushing to make it to work on time. On her mind was how she was going to magically make the UGX 50,000 in her pocket last until pay day which was ten days away. Suddenly, a large lorry swerved into their lane forcing her rider to brake abruptly.  Samantha and the rider were both thrown off, and the motorcycle landed with a crush on her foot. Samantha was in excruciating pain as good samaritans lifted the motorcycle off her leg.  As luck would have it, an old schoolmate witnessed the accident as he drove by, and hurried to assist. Samantha was rushed to one of the leading health facilities where she was immediately admitted on presentation of her health insurance card. Her treatment which included a foot fracture surgery was covered by her provider. To Samantha, the private, prepaid, medical insurance cover provided by her employers, was indeed a life saver.

Health has been described as the first wealth. Like Samantha, no one plans to get hurt or fall sick, but serious ill health can happen to anyone at any time. Provision of quality health care which may include costs such as surgery, medication, tests, scans, emergency care, consultation fees and others, can be very expensive putting enormous strain on one’s finances.

As a concept, insurance works by pooling together the resources of a large number of people with similar risks to make sure that the few people who do experience loss are protected.

Health insurance is a legal agreement between you (an organization or individual) and a health insurance company. This insurance covers the whole or a part of the risk of an insured person’s incurring medical expenses as stipulated in the policy document. The insurance works either through reimbursement of the insured’s costs incurred or direct payment made to the care provider.  Health insurance organizations offer differing healthcare plans with a wide range of features.

Uganda has a health insurance coverage of less than 2%, mainly driven through employer and community-based schemes. She has some of the highest out-of-pocket costs for health in the East African Region. This means that in the event of an illness or injury of one’s self or a loved one, the cost for treatment is usually met through savings, selling of property, fundraising or borrowing. In March 2021, the Parliament of Uganda passed a national health insurance bill that outlines the general structure for a first-ever national social health insurance scheme. The scheme will increase access to quality health care for more people in Uganda and cushion against the high cost of care offered by private healthcare providers. The Insurance Regulatory Authority of Uganda (IRA) is advocating for expedited operationalization of the bill.

Samantha is fortunate to be one of the few people with a comprehensive medical cover through her employer. She has made a full recovery and is back on her feet at work.