“This scheme removes barriers to accessing healthcare.” – Dr Mark Jacobs, WHO Representative to Lao PDR.
2 September 2019, Vientiane Capital - On 23 September the UN General Assembly in New York will hold a high-level meeting on universal health coverage (UHC). UHC means everyone being able to access the good quality health care they need without it causing financial hardship. Representatives from around the world will focus on the theme, 'UHC: Moving Together to Build a Healthier World,’ and adopt an action-oriented political declaration on extending health coverage. WHO is pushing for action towards the global target of UHC by 2030.
But what does all this mean for a family with a sick child living in a rural area of Lao PDR? We asked Dr Mark Jacobs, WHO Representative to Lao PDR, to explain.
“In the past, accessing health care has not always been easy in Lao PDR. For poor families in remote rural areas, even the cost of travelling to the nearest hospital or health centre can be a major barrier to access.” said Dr Jacobs. To help people overcome the cost barrier, the Lao Government introduced a tax-based National Health Insurance scheme (NHI) in 2016.
NHI means that all Lao citizens can access treatment at public health facilities in 17 provinces, for very small out-of-pocket payments. Poor households identified by their village chiefs; pregnant women, children under 5 and monks are exempted from these co-payments.
Lao National Health Insurance pamphlet detailing co-payment rates for eligible members:
- Health centers (outpatient and inpatient): LAK 5000 (approximately USD 0.55) per visit or admission.
- District hospitals (outpatient): LAK 10,000 (USD 1.10) per visit.
- Central hospital (outpatient): LAK 20,000 (USD 2.20) per visit.
- Provincial and regional hospitals (outpatient): LAK 15,000 (USD 1.60) per visit.
“It was a big step towards achieving UHC for the Lao people.” said Dr Jacobs, speaking about the National Health Insurance Law passed in 2018.
In July 2019, Ministry took another step towards pooling funds and risks, with the merger of the formal- employment sector schemes into the NHI. This means that the NHI now covers people in formal employment (civil servants and private sector employees who previously came under the National Social Security Fund) and Lao people who either do not work, are self-employed or work in the informal economy.
“I congratulate the Ministry of Health for their continued commitment and action towards equity and efficiency in health financing. WHO is walking alongside the Lao government on the road to Universal Health Coverage.” said Dr Jacobs.
The WHO Country Office in Lao PDR with financial support from the Republic of Korea, European Union and GAVI, has been supporting the Ministry of Health in the development and implementation of the scheme.
However, there are challenges. For example, people’s awareness of their rights under NHI remains limited. The Ministry of Health has produced posters and leaflets, and is working on a TV and radio spot, to explain how NHI works, including the entitlements and obligations of citizens. For example, they need to provide some sort of proof they are covered by NHI when they go to the hospital or health centre. Acceptable forms of proof would be showing their official “family book”, a Lao identity card, or a letter from their village chief.
Dr Jacobs views these awareness-raising efforts as vital. “Most people in Lao PDR now have the right to access health care at minimal cost. But they can only exercise this right if they know they’ve got it. That’s one of the things we are working on with the Ministry of Health.”
For more information, in Lao language, on NHI, please call hotline number: 1509 (only works in Lao PDR).
About universal health coverage (UHC):
Universal health coverage (UHC) is about ensuring all people and communities have access to the quality health services they need, without suffering financial hardship. It is one of the key components of the UN Sustainable Development Goal 3 – Good Health & Wellbeing for All. WHO is working with its Member States to extend UHC to at least one billion more people across the world by 2023.
For more information on UHC please visit:
https://www.who.int/westernpacific/our-work/universal-health-coverage