Investigating the Inclusion of Vertical Programmes in Health Benefit Packages

Zambia has been steadily working towards achieving Universal Health Coverage (UHC) since the 1990s. Achieving UHC is a crucial part of Zambia’s Vision 2030, Zambia’s strategy for achieving its goal of being a prosperous, middle-income country by 2030. Zambia’s UHC ambition rests primarily on the delivery of two Health Benefits Packages (HBPs): the National Health Care Package (NHCP) and the National Health Insurance Management Authority (NHIMA) Benefits Package; alongside other packages delivered in part through external financing.

In this case study we review the integration of vertical programmes in the country’s two prominent HBPs. Despite its relevance for low- and middle-income countries seeking to achieve UHC, there is a gap in the literature on how countries manage the inclusion of disease programmes in the HBP, especially when countries significantly rely on health funding from external partners, such as in Zambia.

Using the lens of the local policy context, we address the following key evaluation questions:

  1. How were the two HBPs developed and how were entitlements prioritised?

  2. What was the initial decision to exclude or include disease programmes into the HBPs?

  3. What contextual factors were important in shaping those policy-decisions?

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