Health coverage and financial protection in Uganda: A political economy perspective

In this article, the researchers analyse the Ugandan experience of health financing reforms with a specific focus on financial protection.  After almost 20 years of abolishing user-fees to improve accessibility to health services for the population, the incidence of catastrophic health expenditures is still very high in Uganda. The health financing system does not provide a pooled prepayment scheme such as an integrated health insurance scheme at the national level.

The study finds that the health financing landscape remains extremely fragmented, and there is lack of government stewardship to support community-based initiatives to improve health coverage. By examining the negotiation process for health financing reforms through a political economy perspective, this article intends to advance the debate about politically-tenable strategies for achieving UHC and widespread financial protection for the population.

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Maria Nannini
Mario Biggeri
Giovanni Putoto