Jamaica

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Latin America and the Caribbean

7.8%CHE/GDP

11.1%OOP/CHE

19%GGHE-D/GGE

17BGDP (USD)

2.8MPopulation

Jamaica is an island in the Caribbean with a population of about 2.8 million people in 2021.^[1] The country obtained its independence from the United Kingdom of Great Britain and Northern Ireland in 1962. The first major piece of legislation on health financing (for specific populations) was an addendum to the National Insurance Act. Under this legislation, compensation for health care was initially introduced as part of a larger package of services, which included “old age benefit, invalidity benefit, widow’s or widower’s benefit, orphan’s benefit and special child’s benefit”. Funded by employer and employee compulsory contributions (pay-as-you-go), cash benefits for medical treatment and pharmaceuticals were provided to beneficiaries with work-related accidents or illnesses. In the 1970s, the government explored universalism in a green paper on Jamaica’s national health system, which the subsequent economic downturn ultimately derailed. Subsequently two channels improved access to health care: the free National Health Fund, established in 2005, which offsets the cost of pharmaceuticals for 15 priority chronic conditions and has grown in popularity, and the abolition of user fees in public facilities in 2008.

Government response to high out-of-pocket spending

In 2021, out-of-pocket (OOP) expenditure on health was 13.1% of current health expenditure (CHE), a significant decrease from 29.1% in 2005. Although general government health expenditure (GGHE) as a percentage of general government expenditure was 16.2% in 2021,^[2] there is a positive trend in GGHE as a percentage of CHE, going from 49.1% in 2005 to 71.2% 2021,^[3] showing growth in public spending for health. The universal health coverage (UHC) monitoring report of 2023 shows a UHC service coverage index of 74 for Jamaica in 2021.

Health challenges and potential approaches

Jamaica faces a double burden of disease with noncommunicable diseases growing while communicable diseases remain present. The COVID-19 pandemic increased the number of people experiencing poverty,, and negatively affected people’s ability to access health care. Jamaica’s Vision for Health 2030 – Ten Year Strategic Plan 2019–2030 sets out the following in its third strategic goal.

In the short and medium-term, it is recommended to consolidate the existing finance base to ensure implementation of a health benefit package/National Health Insurance (NHI) scheme, through:

The gradual increase in direct government funding toward the PAHO benchmark on 6% of GDP as public investment in health;
The establishment of a health care reserve (The Health Fund) under the MOHW for particular discretionary investments related to the Vision for Health 2030 Plan implementation.

The long-term recommendation is the development of the basis for establishing two strategic finance sources to complement the existing government finance sources:

The establishment of a National Health Insurance (NHI) scheme;
The implementation of a series of policy measures to promote efficiency gains and spending.

The 2019–2030 strategic plan is strengthened further by the Ministry of Health’s discussion paper on financing the cost of healthcare in Jamaica.

References

[1] World Health Organization, Global Health Expenditure Database, NHA Indicators (choose country)

[2] World Health Organization, Global Health Expenditure Database, Indicators and Data (choose country)

[3] World Health Organization, Global Health Expenditure Database, Health Expenditure Profile (choose country)