Health Care Financing Under Structural Adjustment:
Some Reflections from the Health Insurance Experience of Khartoum State, Sudan
Abdul Hameed Elias Suliman
Abstract:
The
study aims at investigating the different aspects associated with the adoption
of health insurance as financing mechanism for curative health services in the
Sudan. Specifically, it aims at examining the general features of the insurance
plan and its likely impact on utilization, access, efficiency, and quality of
the services provided under the insurance scheme. The study also attempts to
examine the potentials and limitations of the scheme.
The research was conducted in Khartoum State, which is a pioneering State
in adopting the insurance plan. Both primary and secondary data have been used
in the study. Primary data were collected through a household survey conducted
in three residential areas. The total sample size, randomly selected, is 341
households of which 210 are insured and 131 are uninsured.
One of the main findings of the study is that the insurance scheme has
contributed to overcoming many shortcomings associated with the application of
user charges financing such as scarcity of financial resources for the health
sector and lack of access to health services. The study has also revealed that
the health insurance programme has positive implications for the utilization of
public health services and provision of equal access to health services.
The study recommends expansion of the insurance coverage to include all
segments of the population, injection of extra financial resources into the
health sector, reduction of the negative effects of the insurance scheme such as
adverse selection and moral hazards, and rationalization of resource use. The
quality of the services should be enhanced and incentives should be provided to
the staff.