The knowledge and views of teachers in government educational institutions in Kampala district on the proposed social health insurance scheme in Uganda.

Abstract

The government of Uganda intends to introduce Social Health Insurance (SHI), starting with formal employees in the public and private sectors. For its successful implementation, key stakeholders need to be brought on board at the planning and design stage of the scheme. They need to understand and accept the principles, rationale and procedures of the scheme. Teachers, though low earners in the Ugandan setting, are the majority cadre of formal employees and thus key stakeholders in the proposed SHI scheme in Uganda. This study set out to find their knowledge and attitudes about the proposed scheme, just before the scheme started in July 2007. It was conducted on teachers in government educational institutions of the urban Kampala District, including primary and secondary schools and three universities. It was found that almost 60% of the teachers were ignorant about the proposed policy and the rest had scanty and often incorrect information. They did not want extra deductions from their meager salaries of between US$ 100 - 200 per month and the majority preferred single annual contributions, not monthly deductions. They felt they had been neither sufficiently educated nor consulted about the scheme. They were wary of a possibility of management of the scheme by the government and had no confidence in a government mechanism, due to recent history of corruption and mismanagement of public funds. They expected to get a wide benefit package for their entire families, which was beyond what is in the proposed scheme. The paper recommends intensified education about the proposed scheme for key stakeholders such as teachers, and their involvement in the design of their scheme, passing through their professional associations. It also recommends that government engages in confidence-building activities with the stakeholders of the scheme, to ensure acceptability of a government-mooted programme.