Document Type : Commentary
School of Medicine, Uganda Christian University, Mukono, Uganda
School of Public Health, Gudie University Project, Kampala, Uganda
Institution of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON, Canada
Faculty of Social Sciences, Ndejje University, Kampala, Uganda
College of Health Sciences, Makerere University, Kampala, Uganda
Uganda introduced health financing reforms that entailed abolition of user fees, and in due process planned to introduce a National Health Insurance Scheme (NHIS). This paper accentuates a contextual and political-economic analysis that dispels the fears and misconceptions related to introduction of the insurance scheme. The Grindle and Thomas model is used to depict how various factors affect decision making by policy elites concerning a particular policy at a particular time. Drawing lessons from the sub-Sahara region and in particular, Ghana and Rwanda’s experience, it is clear that the political will of the executive led by the president in many countries is a key determinant in bringing about health reforms. In this paper, we provide insights based on contextual and political-economic analysis to countries in similar setting that are interested in setting up NHISs.