Feasibility of an Insurance Program for HIV/AIDS Financing in Uganda

ABSTRACT

This paper presents the results of a U.S. Agency for International Development-funded project in Uganda to develop a new financing mechanism for HIV/AIDS services for government workers.Presently; the service delivery and financing systems for HIV/AIDS care are a mix of specialized vertical programs and health care providers from public and private sectors. The integrated financingprogram (being designed as a pilot) is to develop a new approach for financing all HIV/AIDS services in a more coordinated way; allowing financing from multiple sources (donors; employer; and worker contributions) to support service delivery by a network of full-service providers (both public and private) that can be chosen by enrollees. The concept is to establish an independent entity to collect premiums and make payments to qualified providers of covered services on behalf of workers and their dependants. Premiums are established on the basis of a formal costing study of a comprehensive HIV/AIDS benefit package completed in 2004. The paper describes the financing concept and related governance; the model developed for premium calculation; the provider payment design; a survey of government workers done in 2005; and the issues relating to the feasibility of developing an integrated insurance model for HIV/AIDS care in Uganda including issues related to governance; copayments; and relationship to ongoing social health insurance activities