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Evaluating access to National Health Insurance Scheme Services A case study of outpatient care at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia

Author

Listed:
  • Wesley Mwambazi

    (University of Zambia)

  • Mubanga Mpundu

    (University of the Western Cape)

Abstract

Access to health insurance is vital for achieving Universal Health Coverage, yet barriers such as high costs, inadequate coverage, and systemic inefficiencies often impede access to necessary health care. This study evaluated access to the National Health Insurance Scheme-provided services among enrollees at the outpatient department (OPD) of Levy Mwanawasa University Teaching Hospital (LMUTH) in Lusaka, Zambia, chosen for its role as a pioneering NHIS-accredited facility and its significance as a major publicly funded referral hospital. Data were collected in May 2024 from 270 systematically sampled NHIS enrollees at the OPD of LMUTH using an interviewer-administered questionnaire. Descriptive analysis revealed a balanced gender distribution, with most respondents aged 35 and above, married, holding tertiary education, and earning a monthly Zambian Kwacha (ZMW) of 20,000 or less. The thematic analysis using NVivo uncovered positive and negative experiences with NHIS services, highlighting issues such as medical service availability, drug shortages, service delays, technological problems, communication challenges, equity in service delivery, and coverage gaps. The key policy implications for improving access to NHIS services include enhancing supply chains, digital infrastructure, coverage to rural areas, staff training, public awareness of the NHIS, and information technology systems. Key Words:national health insurance scheme, thematic analysis, accessibility, affordability

Suggested Citation

  • Wesley Mwambazi & Mubanga Mpundu, 2024. "Evaluating access to National Health Insurance Scheme Services A case study of outpatient care at Levy Mwanawasa University Teaching Hospital in Lusaka, Zambia," International Journal of Research in Business and Social Science (2147-4478), Center for the Strategic Studies in Business and Finance, vol. 13(7), pages 593-605, October.
    • Handle: RePEc:rbs:ijbrss:v:13:y:2024:i:7:p:593-605
    DOI: 10.20525/ijrbs.v13i7.3654
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