Achieving universal health coverage (UHC) is a key strategic goal for the government of Zambia. In pursuit of UHC, the National Health Insurance Management Authority (NHIMA) is extending health insurance coverage to the poor and the vulnerable. This extension requires robust estimates of the cost and fiscal implications to the government, and the National Health Insurance Scheme (NHIS).

Efficient service delivery in the implementation of the National Health Insurance Scheme (NHIS) in Zambia calls for the speedy processing of claims from health care providers (HCPs) that have provided services to NHIS members and beneficiaries.

As part of the National Health Insurance Management Authority’s (NHIMA) service level agreements with HCPs, all approved claims for services rendered must be paid within 45 days. To enhance efficiency and reduce fraud in claims, NHIMA introduced the biometric claims management system called APACE.

In response to the demand for shorter transaction and waiting time, convenience and adherence to the set COVID-19 prevention health guidelines by the Ministry of Health to stem the spread of the pandemic, the National Pension Scheme Authority (NAPSA, hereafter the Authority) of Zambia implemented an electronic queue management system.

The queue management system allows members, employers and NAPSA to access the following queueing services:

The achievement of universal health coverage (UHC) requires the successful implementation of social health protection policies and interventions. To successfully implement Zambia’s National Health Insurance Scheme (NHIS) as a vehicle for achieving UHC, there is a need for high levels of service readiness and availability in the provision of health services, particularly from the public sector, which covers most of the desired healthcare services.

In March 2020, the coronavirus pandemic broke out in Israel.

What began as a health crisis soon turned into an economic crisis, which led many workers to go on forced unpaid leave and went to the National Insurance Institute (NII) for assistance. There was a need to find creative solutions within the limits of the law and the data available to the NII, and to find workable and quick solutions that would allow the payment of unemployment benefits to unpaid workers.

The National Pension Scheme Authority (NAPSA) was created by an Act of Parliament “The NPS Act” No. 40 of 1996 to provide social security cover to all eligible employees in Zambia in case of retirement, invalidity or death. Since commencement of operations in February 2000, NAPSA has largely focused on the formal sector. However, this sector constitutes only 16 percent (950,000 people) of the total employed population of 5.8 million people (Zambia Labour Force Survey Report, 2014). The remaining 84 percent is made up of employees from the informal sector. 

The National Pension Scheme Authority (NAPSA) was created in 2000 by the Act of Parliament number 40 of 1996 to administer the National Pension Scheme. The Authority's key mandate includes the registration of members, collection of member contributions, prudent investment of the contributions, and the payment of benefits when they fall due. The Authority is also mandated by law to enforce compliance by employers to the provisions of the Act.

In fact, even if electronic transfers have the potential of making capture, transfer and update of information much quicker, the downside of this new practice was a potential loss of crucial information that was - until this time - submitted manually along with the payments.