National Hospital Insurance Fund plays an integral part as the driver towards UHC achievement in the country. Nevertheless there is a need to evaluate effectiveness of its strategies geared to the achievement of UHC. Particularly with reference to efficiency equity and quality of delivery of healthcare.
The objectives of the study were to determine the extent to which National Hospital Insurance Fund premium contributions rates and the effect of capitation rates affects UHC implementation.
The study was based on the conventional health insurance theory. Furthermore the study relied on social exchange theory that espouses the concept of costs and benefits to predict behavior and that individuals chose strategies that helped them to incur low costs while keeping their reward high. The study also reviewed previous studies related to universal health coverage. The study then examined National Hospital Insurance Fund as a case study and its contents mainly: - benefit package and awareness new premium contribution rates and capitation. The data was analyzed using both descriptive and inferential statistics.
The study established that the government provides a legal framework for ensuring a health care delivery system that is driven by the people while bridging the gap on geographical access by providing for a devolved system of governance.
From the above findings of the study premiums capitation influenced access to universal health coverage this implies that the revamped NHIF is influencing access to UHC by facilitating contracted health service providers in a timely manner despite the initial challenges the mode of payment is working thereby supporting and end enhancing UHC. The findings contradict a study by Bain and Ebuenyi 2017 who stated that efficient health care system is about pooling risks by definition every universal health care system is insurance system. In turn the very nature of insurance implies resource allocation from those in good health towards sick. Therefore domestic political compact is needed to set up modalities of how the insurance premiums are paid to what extent resource transfers will take place between healthy and sick but also between generations and between higher and lower income strata in society.