Zambia: Zambia's National Health Insurance Cuts Costs for Older People, but Funding Gaps Limit Its Potential - Study

What the report says

A study published by The Conversation Africa and carried by AllAfrica says Zambia’s National Health Insurance Scheme is helping older adults in Kitwe reduce healthcare costs and reach services more easily, but it is being held back by funding and system pressures. The analysis was written by Malizgani Paul Chavula and Cosmas Zyambo and focuses on how the national scheme, introduced in 2019, works for elderly people in a north-central district that also serves patients from surrounding rural areas.

According to the article, the scheme exempts people aged 65 and above from contributions, while younger adults in some groups pay income-based amounts. Researchers said interviews with elderly patients, health workers and administrators showed clear benefits: lower out-of-pocket spending, broader access to accredited public, private and mission facilities, and outreach efforts that helped register vulnerable people. The authors noted that some participants were able to obtain expensive procedures with little direct payment.

The report also highlights persistent problems. Medicine shortages, long travel distances for rural residents, staffing constraints, infrastructure limits and delays linked to pre-authorisation or technical failures were said to weaken the scheme’s impact. Health workers and administrators also described rising demand and limited growth in the health budget.

The study argues that Zambia will need stronger financing, better oversight, more facilities and improved supply and workforce support if the insurance system is to deliver broader universal health coverage for older people.