Adolescent Health Insurance And Access: Missing Opportunities

Lazarus Sauti

Most adolescents in rural Zimbabwe aged 10-18 are medically uninsured due to poverty and other socio-cultural reasons.

Addressing journalists at a ZimSelector Journalists Insurance Mentorship programme at Holiday Inn Hotel in Harare recently, Cimas Medical Aid Society chief executive, Vulindlela Ndlovu said less than 10 percent of the population in Zimbabwe is covered by health insurance and medical aid.

Health insurance is an insurance policy that covers and/or shares the risk of a person incurring expenses associated with healthcare whilst medical aid covers medical conditions according to scheme rules and managed health care protocols.

“Out of a total population of around 14 million, only about 1.3 million are insured (Health insurance and Medical aid),” said Ndlovu.

Without doubt, medically uninsured adolescents are less likely to have a regular source of primary care compared with those who have insurance.

“Rural girls are mostly affected,” said gender activist, Daphne Jena. “The availability of health services for girls in remote areas is strongly affected by the ability to pay for those services through medical insurance.

Jena also said girls who are medically uninsured time and again receive care late in the development of a health problem.

“Consequently, they are at higher risk for hospitalisation for conditions open to timely outpatient care and for missed diagnoses of serious plus life-threatening conditions,” she said.

The National Academy of Medicine, formerly called the Institute of Medicine – an American non-profit, non-governmental organisation, emphasises that being medically uninsured has a negative effect on health-related outcomes and chronic conditions among adolescents.

In one of its studies, the non-governmental organisation scrutinised the impact of uninsurance on families, children, and adolescents and found out that adolescent girls who lack health insurance coverage have worse access to needed health services than those who have coverage.

Pan-African Positive Women Coalition Zimbabwe coordinator, Alice Shayahama, says insurance companies are missing a lot of opportunities simply by ignoring the needs of adolescents, especially girls.

She also declares that health insurance coverage and access among adolescents are crucial steps not only to close the gap, but to ensure that adolescents receive the services they require too.

“To achieve this, more resources should be channelled to rural communities to fight poverty and diseases,” she said, adding that as a way to bring health care closer to adolescents, school health services may have advantages in terms of access, impartiality and openness to adolescents’ needs.

Gender and development expert, Abigail Dovi, also believes that raising adolescent health insurance and access awareness can bridge the gap between the medically insured and uninsured adolescent girls in rural areas.

“Stakeholders should not only strengthen their work on violence against girls and women in the countryside, but also encourage the sharing of health insurance and medical care ideas,” she advises.

For chief executive of Rozaria Memorial Trust, Nyaradzai Gumbonzvanda, adolescent health insurance is necessary towards keeping girls in schools along with fighting for freedom from all forms of gender-based violence, a fact supported by senior global advisor and researcher for women’s rights, empowerment and partnerships in Africa, Hendrica Okondo.

“To keep girls in schools and end the cycle of diseases and poverty, stakeholders in the health insurance industry should ensure that adolescents have coverage for sexual and reproductive health services, including screening for sexually transmitted infections (STIs), family planning counselling, contraceptives, and pregnancy-related services,” said Okondo.

Significantly, the Insurance and Pensions Commission is targeting insurance penetration in the country to ensure that even adolescent girls and boys are well catered for.

IPEC public relations officer, Lloyd Gumbo, said this growth will be driven by robust awareness programmes that promote the uptake of insurance products in urban and rural set-ups.

The World Health Organisation, a specialised agency of the United Nations that is concerned with international public health, noted in its factsheet titled ‘Adolescent responsive health systems’ that adolescent girls have significant needs for health services as they pose different challenges for the health-care system than children and adults due to their rapidly evolving physical and emotional development.

“Accordingly, progress in the direction of universal health coverage requires a transition from adolescent-friendly projects to adolescent-responsive health systems. Services geared for adolescents, thus, need to go beyond sexual and reproductive health to address the full range of adolescents’ health and development needs,” read the factsheet.

The international public health body also persuaded stakeholders in health insurance to expand their coverage to include mainstream services, school health services and mobile technology services like e-health and m-health.

Summing up, Ndlovu said insurance companies are indeed expanding their coverage to cater for the needs of adolescent girls and boys, but they are facing challenges such as foreign currency shortages, shrinking formal employment, fraudulent claims and the declining public health system.

He, however, urged the government to increase the ministry of Health’s budget allocation, which is at +/- 9.4 percent well below the recommended 15 percent per Abuja Declaration, to revive the health sector in the country.