Population Characteristics and Their Implications on the Benefit Basket of National Social Health Insurance Scheme in Sierra Leone: A Prospective View

Abstract

Background. The government of Sierra Leone introduced social health insurance (SHI) scheme to provide universal health coverage to people. This study was carried out to assess the population characteristics and their implications on the benefit basket of the proposed national health insurance scheme. Methods. A cross-sectional study design was employed in six selected districts in Sierra Leone. Quantitative data were collected for this study through the use of semistructured questionnaires with a sample of 1,185 respondents. Data were analysed using descriptive and inferential statistics. Statistical analysis was run at 5% significant level using Stata 14.0 software. Results. The study found that most (83.54%) of the respondents affirmed that children below 18 years should be excluded from premium payments and as high as 71.65% also stated that pregnant women should be excluded as well. The majority, 63.69%, of the respondents want lactating mothers to be excluded from premium payments. Also, 79.87% of respondents wanted mentally challenged persons not to pay premium, while a significant proportion (84.26%) of respondents further affirmed that the aged (above 70 yrs) should also be excluded from premium payment. Most household heads (89.71%) preferred the accreditation of public health facilities. Regarding the level at which healthcare services should be covered by the scheme, 61.45% preferred the primary care services, 89% mentioned secondary care services, and 98.93% affirmed the provision of tertiary care under the scheme. As for the type of care that should be covered by the scheme, 98.66% and 99.73% affirmed outpatient and inpatient care, respectively. Conclusion. From the findings on population characteristics and their implications on the benefit basket for the proposed nation social health in Sierra Leone, most of the household heads want exemptions from paying premium for a section of the population. This provides a clear insight for policy makers into the formulation of the benefit basket.