Health 17 April 2026 Daily Monitor (Uganda)
Museveni Orders Urgent Redesign of National Health Insurance Amid Shrinking Aid and Rising Medical Costs
President Yoweri Museveni has instructed the Ministries of Health and Finance to fast-track a contributory National Health Insurance Scheme (NHIS) as donor funding drops and out-of-pocket health expenses push families into poverty. Experts highlight the urgency while sharing lessons from successful models like NSSF voluntary savings. Source: https://www.monitor.co.ug/uganda/news/national/how-shrinking-aid-is-reviving-national-health-insurance-drive-5427778
President Yoweri Museveni recently directed the Ministries of Health and Finance to redesign Uganda’s long-stalled National Health Insurance Scheme (NHIS) for quicker rollout. This move addresses declining donor aid and the heavy burden of medical bills on households.
The directive emerged during Cabinet talks on the 2026/2027 budget. Dr. Ramathan Ggoobi, Permanent Secretary at the Ministry of Finance, noted the President favors a contributory model suited to Uganda, rejecting prior Health Ministry plans seen as overly reliant on government funds.
Out-of-pocket payments make up 31% of health spending, per Uganda Bureau of Statistics data. This often slashes household food intake by 90% and drives illness-induced poverty, affecting 4% of Ugandans who spend over 25% of income on care.
Donor funding for health has plummeted from 49% in 2022 to 23% in 2025, per a report by Uganda National NGO Forum and CEHURD. Government covers just 22%, households 31%, and insurance under 5%, creating vulnerabilities in services like HIV/AIDS and maternal health.
Emily Onziru, 36, from Masanafu slum, exemplifies the crisis. Suffering from rheumatic heart disease, she needs Shs27 million surgery but survives on Shs150,000 monthly drugs, draining family resources and limiting her productivity.
Experts like Prof. Freddie Ssengooba from Makerere University urge boosting the health budget first, viewing NHIS as a long-term fix. He suggests partnering with NSSF, which gathered Shs114 billion in voluntary savings from 68,000 people in one year.
Dr. Ian Clarke calls for a multi-stakeholder group including academia, private sector, and NSSF to lead redesign. Health Minister Dr. Jane Ruth Aceng proposes Shs15,000 monthly contributions, with reduced rates for indigents.
Despite challenges, progress includes life expectancy rising to 68 years and 91% of Ugandans near health facilities. Yet per capita spending lags at $50 annually, half the recommended level.
This story originally appeared in the Daily Monitor.