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Case Study

Challenge

Access to affordable health care is one of the great challenges faced by low-income people in Uganda. The need for quality care in Uganda is critical - 10% of the adult population is infected with HIV, one million children are AIDS orphans, and there is one doctor for every 20,000 people in the country. Many people have to walk miles to the nearest health center in the rural areas.

Photo: Rodney Matovu

Launching Kabale Dairy Health Cooperative in Kabale Stadium.

In 2003, insurance options grew from ten health plans serving 1,500 members to forty-eight health plans serving 5,000 members.

Initiative

USAID implemented a cooperative health system in Uganda under the umbrella organization Uganda Health Cooperative (UHC). USAID’s goal is to expand the role of the private and commercial sectors in improved health by increasing the use of quality family planning and other health products and services. USAID developed a financial strategy to improve access to affordable quality health care for low-income people in Uganda. The program provided crucial assistance to UHC in designing a number of health insurance programs in various regions of the country.

As part of the CMS program, USAID built a health care system that is paid for and run by the people it serves through the UHC. Currently-enrolled health plan groups include schools, tea and forestry cooperatives, and self-help groups. Plan members make decisions as a group about which services to buy, thereby determining the price of their periodic dues. Members also give the providers feedback about the services.

Results

The popularity of cooperative health plans is growing due to the Ugandans’ familiarity with cooperatives in agriculture and business, which are important aspects of their lives. In 2003, insurance options grew from ten health plans serving 1,500 members to forty-eight health plans serving 5,000 members. The program recruited up to 15,000 new clients - mainly from schools and clergy - to join this program. Ugandan health officials now recognize that the country does not have enough money to support a central health care system and are monitoring the cooperatives’ successes to see how this model can complement the government-run health system.

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