An Assessment of Community-Based Health Financing Activities in Uganda

This document presents an assessment of community-based health financing (CBHF) schemes in Uganda that the "‘Partners for Health Reformplus Project" (PHRplus) undertook in conjunction with the ‘"Uganda Community Based Health Financing Association" (UCBHFA) in September–-October 2004. The assessment aims to:

• Provide PHR plus with the appropriate background to successfully implement CBHF strengthening activities;
• Examine good practices/models and key obstacles to sustainability in terms of:
  • Governance and management;
  • Financial management and viability;
  • Risk management;
  • Marketing and membership incentives;
  • Community buy-in;
  • Impact on quality of life of members.

The assessment is based on informant interviews and focus group discussions, supplemented by recorded data from the UCBHFA and a desk review of relevant literature. It presents the following findings about scheme membership:

• Members report a significant improvement in quality of life;
• Management structures and members role in the decision-making process are diverse, with varying degrees of community involvement;
• Membership base is a sound predictor of cost recovery;
• Schemes to improve accounting mechanisms and financial management are needed;
• Members understand risk management and insurance concepts. Some risk management techniques should be investigated further;
• Marketing research can improve the identification and sensitization of potential new scheme members;
• There is a need for increased sensitization among scheme members regarding insurance concepts;
• There is a need to re-examine concepts of scheme sustainability and scheme health.