Makerere University Reports Findings in Health Services (Expectations of clients, insurers, and providers: a qualitative responsiveness assessment among private health insurance sector in Kampala-Uganda): Health and Medicine – Health Services

2023 DEC 15 (NewsRx) -- By a News Reporter-Staff News Editor at Health & Medicine Business Daily -- New research on Health and Medicine - Health Services is the subject of a report. According to news originating from Kampala, Uganda, by NewsRx correspondents, research stated, “There is less attention to assessing how health services meet the expectations of private health insurance (PHI) actors, clients, insurers, and providers in developing countries. Interdependently, the expectations of each actor are stipulated during contract negotiations (duties, obligations, and privileges) in a PHI arrangement.”

Our news journalists obtained a quote from the research from Makerere University, “Complementary service roles performed by each actor significantly contribute to achieving their expectations. This study assessed the role of PHI in meeting the expectations of clients, insurers, and providers in Kampala. Lessons from this study may inform possible reviews and improvements in Uganda’s proposed National Health Insurance Scheme (NHIS) to ensure NHIS service responsiveness. This study employed a qualitative case-study design. Eight (8) focus group discussions (FGDs) with insured clients and nine (9) key informant interviews (KIIs) with insurer and provider liaison officers between October 2020 and February 2021 were conducted. Participants were purposively selected from eligible institutions. Thematic analysis was employed, and findings were presented using themes with corresponding anonymized narratives and quotes. Client-Provider, Client-Insurer, and Provider-Insurer expectations were generally not met. Client-provider expectations: Although most facilities were clean with a conducive care environment, clients experienced low service care responsiveness characterized by long waiting times. Both clients and providers received inadequate feedback about services they received and delivered respectively, in addition to prompt care being received by a few clients. For client-insurer expectations, under unclear service packages, clients received low-quality medicines. Lastly, for provider-insurer expectations, delayed payments, selective periodic assessments, and inadequate orientation of clients on insurance plans were most reported. Weak coordination between the client-provider and insurer did not support delivery processes for responsive service. Health care service responsiveness was generally low. There is a need to commit resources to support the setting up of clearer service package orientation programs, and efficient monitoring and feedback platforms.”

According to the news editors, the research concluded: “Uganda’s proposed National Health Insurance Act may use these findings to: Inform its design initiatives focusing on operating under realistic expectations, investment in quality improvement systems and coordination, and efficient and accountable client care relationships.”

For more information on this research see: Expectations of clients, insurers, and providers: a qualitative responsiveness assessment among private health insurance sector in Kampala-Uganda. BMC Health Services Research, 2023;23(1):1358. BMC Health Services Research can be contacted at: Bmc, Campus, 4 Crinan St, London N1 9XW, England. (BioMed Central - http://www.biomedcentral.com/; BMC Health Services Research - http://www.biomedcentral.com/bmchealthservres/)

The news correspondents report that additional information may be obtained from Tonny Tindyebwa, Dept. of Disease Control and Environmental Health, School of Public Health, Makerere University, Kampala, Uganda. Additional authors for this research include Richard Ssempala, Aloysius Ssennyonjo, Chrispus Mayora, Micheal Muhoozi, Joan Tusabe, Paul Mukama and Ssengooba Freddie.

The direct object identifier (DOI) for that additional information is: https://doi.org/10.1186/s12913-023-10386-x. This DOI is a link to an online electronic document that is either free or for purchase, and can be your direct source for a journal article and its citation.

The publisher’s contact information for the journal BMC Health Services Research is: Bmc, Campus, 4 Crinan St, London N1 9XW, England.

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