SCHOOL OF BUSINESS, ECONOMICS AND MANAGEMENT

ASSESSMENT ON THE EFFICIENCY OF NATIONAL HEALTH INSURANCE

SCHEME ON ITS PRIVATE ACCREDITED PHARMACIES IN KITWE.

BY

Nkhandu Silunyange

BACT1621203

Bachelor of Science in Actuarial Science

Submitted to the Business, Economics, and Management faculty in partial completion of

the requirements for the award of a Bachelor's Degree in Science in Actuarial Science

2022.
Contents
Chapter 1 Introduction 2
Introduction 2
Study Background 2
Statement of the Problem 3
Research Objectives 4
General objective 4
Specific objectives 4
Research hypotheses 4
Significance of the study 4
Scope of the study 5
Limitations 5
Key Definitions 5
REFERENCES 6
CHAPTER 1 INTRODUCTION
Introduction
The research focuses on the impact of Zambia's National Health Insurance Scheme on
health-care delivery in the country. It will take place in Kitwe. This chapter delves into
the research issue and the study's foundation.

Study Background
Currently, Zambia's government-run health facilities provide free basic healthcare
packages at the primary (district) level. The free services are provided under the
National Health Care Package (NHCP), which has been hit with "capacity constraints"
and limited funding, resulting in services not reaching those who need them the most.

Despite the fact that Zambia's health-care delivery system is centered on drugs and
medical supplies, the Ministry of Health Zambia (2011) stated that "it is not easy for the
government to offer universal health-care coverage due to financial constraints leading
to drug and medical-supply shortages in hospitals."

Based on the above statement, the ministry decided to reconsider the implementation of
a National Health Insurance Scheme (NHIS), an issue that successive Zambian
governments have debated since 1991. It was in this same year, 2011, that the need to
implement the NHIS in accordance with the Universal Health Coverage agenda gained
traction.

This political will culminated in the signing of the National Health Insurance Act No. 2 of
2018, which resulted in the creation of the National Health Insurance Scheme (NHIS)
under the management of the National Health Insurance Management Authority
(NHIMA,2021).

In accordance with the National Health Insurance Act, the National Health Insurance
Management Authority's board of directors was inaugurated on March 15, 2019.

Since then, the NHIMA Director General and the inception management team have
been appointed to facilitate the implementation of the National Health Insurance
Scheme, putting Zambia on the path to providing its citizens with access to quality
essential health-care services.

Statement of the Problem

Section 4 of the National Health Insurance Act No. 2 of 2018 made contributions to the
National Health Insurance Scheme mandatory for public civil servants. Nonetheless,
despite these contributions, client and patient dissatisfaction with health care service
delivery in Zambia continues to rise.

MakanDay Media Centre conducted a survey in six provinces (Eastern, Luapula,

Muchinga, Northern, Copper belt, and North Western) in 2021, which revealed that
many state hospitals and clinics do not have access to life-saving drugs. Alternatively,
they are given prescriptions and instructed to obtain the drugs from private pharmacies.
In a nutshell, this survey revealed CRITICAL shortages of essential drugs and medical
supplies in many Zambian state hospitals and clinics.

As a result, the study intends to thoroughly investigate how Zambia's national health
insurance scheme has impacted health care service delivery.

Research Objectives

General objective

The main objective of this study is to Assess the efficiency of the Nationalof National
Health Insurance Scheme on its Private Accredited Pharmacies in Kitwe.

Specific objectives

1. To compute the number of essential medicines distributed in the years 2020 and
2021
2. To compute the means and variances of the levels of essential medicines for the
year 2020 and 2021.
3. To test whether the mean number of essential medicines for the year 2021
exceeds the mean number of essential medicines for the years 2020.
 4. To test whether the variation in amounts of essential medicines is the same for
both years.

Research hypotheses
a. H0: The mean amounts of essential medicines for the year 2020 is equal to that
of 2021.
H1: The mean amounts of essential medicines for the year 2020 is not equal to
that of 2021.
b. H0: the variation in amounts of essential medicines is the same for both years.
H1: the variation in amounts of essential medicines is not the same for both
years.

Significance of the study

The study is aimed at assessing the effect of introduction of national health insurance
on the health care service delivery. Since the establishment of the National Health
Insurance Management Authority (NHIMA), pursuant to section 4 of the nation
insurance act no 2 of 2018 that enabled the compulsory National Health Scheme, it is
paramount that the system is visited and investigated in order to get more insight for
improvement. For the fact that the contributions for national insurance is compulsory, it
is also important that we revisit the process in order to inform the contributors and raise
their confidence and knowledge on the value of their contributions.

Scope of the study

The study will be conducted in Kitwe. The study will concentrate on the number of
essential medicines prescribed and recognized by the World Health Organization
(WHO). The study will collect secondary data from registers and files and use it to
compute and compare the number of essential medicines thatmedicinesthat were given
by pharmacies for the year 2020 and the year 2021.

The study will not include non-essential medicines as these medicines are considered
to be very similar to existing medicines in the same category with essential drugs and
excluding these Non-Essential drugs is a cost-savings feature of a prescription benefit
plan.
Limitations
Due to time constraints, the study will only be undertaken in one district. The study is a
quantitative approach type of study and will be using private and public documents of
which despite getting permission from necessary authority, full cooperation from the end
users handling these documents will be a challenge.

Key Definitions
1. Essential medicines:are the medicines that "satisfy the priority health care needs
of the population". These are the medications to which people should have
access at all times in sufficient amounts.
2. Non-essential medicines:are products that are very similar to existing essential
medicines in the same category but only have slight differences in the way their
chemistry is designed and how they work.
3. COVID-19- a flulike disease caused by SARS-CoV-2 2 of 2019.
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