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Exploring for-profit healthcare providers’ perceptions of inclusion in the Zambia National Health Insurance Scheme : A qualitative content analysis

Sinjela, Kwangaika Mwala ; Simangolwa, Warren Mukelabai Warren ; Hehman, Lindsey ; Kamanga, Mpuma ; Mwambazi, Wesley Kapaya and Sundewall, Jesper LU (2022) In PLoS ONE 17(5 May).
Abstract

Background In 2019, Zambia introduced the national health insurance (NHI) as a healthcare financing strategy to increase universal access to health care services. The private health sector can complement public sector providers as service providers under the NHI. As such, the NHI Management Authority seeks to accredit for-profit private healthcare facilities in the NHI. Ascertaining factors that influence private-for-profit health providers to participate in the NHI is essential, but the evidence is lacking. In this study, we aimed to explore and characterize perceptions and experiences of for-profit private hospitals, dental clinics, eye clinics, diagnostic centres, and pharmacies regarding their inclusion in the NHI. Methods We... (More)

Background In 2019, Zambia introduced the national health insurance (NHI) as a healthcare financing strategy to increase universal access to health care services. The private health sector can complement public sector providers as service providers under the NHI. As such, the NHI Management Authority seeks to accredit for-profit private healthcare facilities in the NHI. Ascertaining factors that influence private-for-profit health providers to participate in the NHI is essential, but the evidence is lacking. In this study, we aimed to explore and characterize perceptions and experiences of for-profit private hospitals, dental clinics, eye clinics, diagnostic centres, and pharmacies regarding their inclusion in the NHI. Methods We conducted in-depth interviews with owners or management officers of purposively sampled private health care providers in Lusaka, Zambia (n = 22) between May and June 2020. Qualitative content analysis was used to analyse data. Results The findings highlight low awareness of the NHI among providers and a need to understand the NHI. Providers revealed their positions and views on the accreditation process and payment arrangements and stated that their participation would complement the NHI. They also cited conditions to participate in the NHI, highlighted opportunities and challenges of engaging in the NHI, and expressed a need for sustainable ways of governing the scheme. Conclusion The assessment of health providers’ inclusion in the NHI scheme is multifaceted. The results of this study surfaced factors such as raising awareness on the NHI among providers and how their concerns on aspects such as payments can be considered as inputs to enlighten consensual agreements between the NHI authority and health providers in leveraging the private health sector. Private providers’ concerns must be further understood and considered as the NHI strives to include this group as health care providers in the scheme.

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Contribution to journal
publication status
published
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in
PLoS ONE
volume
17
issue
5 May
article number
e0268940
publisher
Public Library of Science (PLoS)
external identifiers
  • pmid:35622836
  • scopus:85130951983
ISSN
1932-6203
DOI
10.1371/journal.pone.0268940
language
English
LU publication?
yes
id
9b103024-c566-4736-9fa4-12892a823827
date added to LUP
2023-01-19 13:44:57
date last changed
2024-04-04 15:57:56
@article{9b103024-c566-4736-9fa4-12892a823827,
  abstract     = {{<p>Background In 2019, Zambia introduced the national health insurance (NHI) as a healthcare financing strategy to increase universal access to health care services. The private health sector can complement public sector providers as service providers under the NHI. As such, the NHI Management Authority seeks to accredit for-profit private healthcare facilities in the NHI. Ascertaining factors that influence private-for-profit health providers to participate in the NHI is essential, but the evidence is lacking. In this study, we aimed to explore and characterize perceptions and experiences of for-profit private hospitals, dental clinics, eye clinics, diagnostic centres, and pharmacies regarding their inclusion in the NHI. Methods We conducted in-depth interviews with owners or management officers of purposively sampled private health care providers in Lusaka, Zambia (n = 22) between May and June 2020. Qualitative content analysis was used to analyse data. Results The findings highlight low awareness of the NHI among providers and a need to understand the NHI. Providers revealed their positions and views on the accreditation process and payment arrangements and stated that their participation would complement the NHI. They also cited conditions to participate in the NHI, highlighted opportunities and challenges of engaging in the NHI, and expressed a need for sustainable ways of governing the scheme. Conclusion The assessment of health providers’ inclusion in the NHI scheme is multifaceted. The results of this study surfaced factors such as raising awareness on the NHI among providers and how their concerns on aspects such as payments can be considered as inputs to enlighten consensual agreements between the NHI authority and health providers in leveraging the private health sector. Private providers’ concerns must be further understood and considered as the NHI strives to include this group as health care providers in the scheme.</p>}},
  author       = {{Sinjela, Kwangaika Mwala and Simangolwa, Warren Mukelabai Warren and Hehman, Lindsey and Kamanga, Mpuma and Mwambazi, Wesley Kapaya and Sundewall, Jesper}},
  issn         = {{1932-6203}},
  language     = {{eng}},
  number       = {{5 May}},
  publisher    = {{Public Library of Science (PLoS)}},
  series       = {{PLoS ONE}},
  title        = {{Exploring for-profit healthcare providers’ perceptions of inclusion in the Zambia National Health Insurance Scheme : A qualitative content analysis}},
  url          = {{http://dx.doi.org/10.1371/journal.pone.0268940}},
  doi          = {{10.1371/journal.pone.0268940}},
  volume       = {{17}},
  year         = {{2022}},
}