On 28 December 2020, the government owned media outlet Fana Broadcasting Corporate released a news item quoting Ethiopian Minister of Health, Lia Tadesse (M.D) who said “More than 32 million citizens have benefited from health insurance Ethiopia.” in a panel discussion aimed at increasing COVID19 awareness and health insurance coverage in the Amhara Regional State of Ethiopia. Considering the gravity of the claim, Addis Zeybe’s HaqCheck set out to understand the details of the claim made by the Minister of Health of Ethiopia.
Health insurance is a type of insurance coverage that typically pays for medical, surgical, prescription drug and sometimes dental expenses incurred by the insured. It is a system where individuals or households pay small contributions or prepayments to get health services at the time of illness and to protect them from catastrophic health expenditures. Ethiopian Health Insurance Agency was established as an autonomous federal organ through Regulation No. 191/2010 issued by the council of ministers.
Addis Zeybe has contacted the Ethiopian health insurance agency and talked with Eyob Gelaye (Senior public relation officer) about the current status of health insurance in Ethiopia. As Eyob said, the agency is working on implementation of two types of health insurance systems in the country;
The first one is the Community Based Health Insurance (CBHI), which is a system that is designed to minimize the pressure of health-related expenses upon parts of the community who are involved in the informal economy sector and to prevent their fall into poverty. CBHI primarily covers essential health service packages at the healthcenter level. The benefits include both inpatient and outpatient services. All types of essential health services that would be covered through out-of-pocket spending at time of sickness are covered by CBHI.
The second type of insurance is the Social Health Insurance (SHI), which comprises the population engaged in the formal sectors of the economy. SHI has been widely implemented in many European, Asian and African countries for years.
Eyob also clarifies that CBHI is being implemented in 770 Woredas and has 23 branches, adding, more than 32 million community members (which is around 29% of the population) benefited from the Insurance scheme. The beneficiaries are involved in the informal economy system. More than 6.5 million of those who were registered in the health insurance system were people who could not afford to pay for their health insurance and the government has covered their expenses.
Addis Zeybe also asked about social health insurance which Eyob said there is no specific date for it’s implementation but there have been some discussions and long term plans to start the program in Ethiopia.
According to Medic east africa – an organization focusing on health care and organizing events in 11 countries – Rwanda has the highest enrolment in health insurance in Sub-Saharan Africa, which covers over 75% of the population (9.6 million out of 12.8 million). Kenya also has 56% coverage which is around 25.7 million of the population.