Actions in Zambia

  • Development of a target operating model for NHIMA

    Start activities
    22-05-2023
    End activities
    13-10-2023
    Partner Institution
    National Health Insurance Management Authority
    Type of Assistance
    Organisational management (structures & functions)
    Code
    2023-05
    Description
    In 2022, NHIMA collaborated with SOCIEUX+ to evaluate its scheme implementation, leading to a review of its Strategic Plan and a transition to the Ministry of Health. Now, NHIMA seeks to develop an independent operating model for HR and scheme implementation, reducing reliance on third-party administrators. This action led by German, Estonian, Belgian, and Polish expertise, resulted in a proposal for a new operating and organizational model and a study visit to the Polish National Health Fund for insights on IT and organizational capacities.
  • Operational Review of the National Health Insurance Scheme in Zambia

    Start activities
    18-04-2022
    End activities
    30-09-2022
    Partner Institution
    National Health Insurance Management Authority
    Type of Assistance
    Institutional capacity building
    Code
    2022-02
    Description
    The purpose of this action was for the National Health Insurance Management Authority (NHIMA) to optimize the management of the National Health Insurance Scheme (NHIS). NHIMA was established by the National Health Insurance Act No.2 of 2018. The Act provided for the establishment of a compulsory National Health Insurance Scheme under the management of NHIMA. The Scheme, as part of the Health Care Financing Strategy of the Ministry of Health, is aimed at providing sound financing of the national health system and enhance universal access to quality insured healthcare services for all Zambians. NHIMA wished to understand where they stand after two years of implementing the Scheme, where are their strengths or weaknesses, and identify potential bottlenecks. NHIMA also wished to gain more knowledge and guidance on strengthening their current health-financing system, as well as to understand possible health financing options in view of attaining universal health coverage. Mobilized experts from Estonia, Finland, France, and Germany accompanied the partner’s reflection in the framework of 3 activities.