Result achieved
A social protection scheme to extend coverage, enhance comprehensiveness and/or increase adequacy of benefits has been adopted or reformed (Step 2)
Number of countries that have adopted or reformed social protection schemes to extend coverage, enhance comprehensiveness and/or increase adequacy of benefits (Step 2)
30.04.2018 ZMB128 Public
Linked projects
Outcome summary
The National Health Insurance Scheme is establishedOutcome achieved
In April 2018, the National Health Insurance (NHIA) (Act no. 2/2018) was signed by the President of the Republic into law establishing the National Health Insurance Scheme. The scheme aims to provide health care to eligible workers in Zambia, including many of those working in the informal economy, and is advancing the country’s ambition to achieve universal health coverage. The National Health Insurance (NHIA) (Act no. 2/2018) prescribes health coverage to be expanding through the creation of a social health insurance scheme, based on compulsory, universal coverage, broad risk pooling and other principles of social insurance. The National Health Insurance (NHIA) (Act no. 2/2018) introduces universal coverage while exempting certain categories of individuals from paying contributions invoking solidarity within the social insurance scheme to ensure coverage for vulnerable groups, including those above 65 years of age, the poor and vulnerable, and persons with disabilities who are unable to work, among others. While not an explicit objective of the National Health Insurance (NHIA) (Act no. 2/2018), the scheme seeks to ensure financial protection against chronic and acute medical illnesses in some cases exacerbated by the effects of climate change and environmental degradation, including occupational exposure to heat stress in the agricultural and construction sectors.
ILO's contribution to the outcome
The NHI bill whose draft was done in the last biennium continued receiving ILO support until its enactment. The ILO, through the Social Protection Programmes, supported the development of NHI draft regulations through legal drafting and other technical support periodically throughout 2018 and 2019. In the wake of its passage and to support the development of its enabling regulations, the ILO supported a cohort of 7 representatives (2 women, 5 men) from Government, social partners and other stakeholders from Zambia to attend the two weeks Social Health Protection course at the International Training Centre (ITC-ILO) in Turin, in July 2018 and to maintain an on-going forum for social dialogue around the implementation of the NHIA in the subsequent months. The ILO provided technical support to the drafting of the legislation, in line with provisions of ILO Convention 130 concerning Medical Care and Sickness Benefits, 1969. The ILO provided support to Ministry of Health in the development of the legislation and to its enabling draft regulations during the course of the biennium. Through its technical advice, the ILO has sought to ensure that the NHIA offers a comprehensive medical insurance cover protecting against a wide range of health risks, including those potentially instigated or exacerbated by climate change effects.