Health insurance engagement

• Sierra Leone’s health sector has significantly underperformed since the end of the civil war

• The Government solicited advice from IGC to help design a social health insurance scheme for the informal sector

• Researchers worked with the Directorate of Policy, Planning and Information (DPPI) providing input on the design of the insurance plan

The Sierra Leonean government had ambitious plans to provide a national social health insurance scheme. The Ministry of Health and Sanitation requested assistance from the IGC in helping to structure, design and evaluate a health insurance programme as a means of expanding health care coverage.

IGC Sierra Leone has been heavily involved in working with the Directorate of Policy, Planning and Information (DPPI) at the Ministry of Health and Sanitation (MoHS) in providing technical input into the design of the insurance programme as well as helping them design an evaluation programme for the proposed social health insurance scheme in Sierra Leone. Prior to the worsening of the Ebola outbreak, the government was embarking on an ambitious scheme to cover the population under a social health insurance scheme.

The IGC team worked with the DPPI, mainly through regular participation in its technical committee meetings, on evaluation design, survey instrument, data analysis as well as and comments on the design of the benefit package and administrative issues for programme implementation. As part of this ongoing engagement, a trip was planned with key stakeholders to Rwanda to use the Rwandan case as a case study in designing the Sierra Leone initiative, and a large evaluation project was approved for funding but was stalled by the Ebola outbreak. Despite the uncertainty around the project moving forward, IGC staff and researchers helped deliver a report detailing design status and roadmap of the proposed insurance programme and the evaluation to the DPPI so that if and when the programme comes up again, there is a reference document that could be used as a guide.

Researchers were embedded in the design, implementation and evaluation of the scheme, though it has been delayed by the Ebola crisis. IGC researchers are involved in the ongoing discussion regarding whether insurance is the right response post-Ebola.