NHI Services at LARC

As an integral part of the Health Sector Reform process, a National Health Insurance Scheme was established in 2000 through an amendment to the Social Security Act.

The launching of a Pilot Project in the South Side of Belize officially established NHI as a purchaser of health services in August of 2001. This year, the National Health Insurance Team celebrates 20 years of Service to Belize. This is quite an accomplishment that could not have been possible without the participation of all the relevant stakeholders; the Government of Belize, Ministry of Health, the NHI Committee, the Social Security Board, the NHI Unit, our registered providers (private, public and NGOs), and of course, the beneficiaries of the program; the NHI clients.

One of the main drivers of the reform process was the move towards universal health coverage for all Belizeans. The reform as it pertains to NHI, promoted the separation of the key functions of the regulator; provider and purchaser of health services.

• The MOH is the regulator of the Health services in Belize. The Ministry is responsible for identifying the health needs of the population covered by NHI, defining the quality health service delivery standards, development of the clinical guidelines and facility regulations that providers must meet.
• NHI is responsible for purchasing the defined package of services from pre- approved registered providers and ensuring that services rendered, meet the requirements stipulated in the contractual agreements.
• NHI registered providers are responsible for delivering the health services in accordance to the standards and Key Performance Indicators negotiated in the contractual process. NHI has applied mixed models of health care delivery that include the participation of both public, private and NGO providers.

The launching of the NHI Pilot project in August of 2001, marked a significant milestone in the Health Sector Reform process. It implemented a new model of care that incorporated all the principles and core values espoused in the World Health Report 2010 publication “Health Systems Financing, the path to Universal Coverage” published 10 years later. Belize became a model for the Caribbean region and provided both technical assistance and shared vital information on contracting model that today is being used in many of the Caribbean island nations.

In January 2006, NHI expanded to the Southern Region. Several major policy changes have been incorporated into the NHI contracts since 2001. For example, the re-defining of the basic package of health care services to include the diagnosis and management of hypertension, diabetes, Asthma, HIV/AIDS, pre and post natal monitoring, treatment of TB, management of acute illnesses, screening for Breast, cervical and prostate cancer and epidemiological surveillance. The following specialist services were included: Ophthalmology, to include diabetic eye exams, diabetic laser surgery, cataract surgery and eye glasses for school age children and post cataract surgery, and deliveries in the Southern Region. In 2011, NHI launched Mercy Clinic, a facility focused on providing exclusive services to the elderly population in Belize City. In 2015, NHI rolled out to Corozal.

Some of the positive intermediate outcomes of NHI include:

• Increased access to Primary Health Care Services to eligible population.
• Reduced out of pocket expenditures of users when accessing key services covered
• Increased quality in the delivery of services evident by the findings of the audits and compliancemonitoring reports.
• Increased access to specific screening services.
• Increase access to essential medications for the management of chronic conditions.
• Increase satisfaction levels expressed by users of the services.

In spite of these achievements, NHI is faced with challenges that will define its strategic direction in the near future. The issue of identifying a sustainable source of funding has been the fundamental challenge to a national roll out. The coming years will be critical as we debate the package of services, the investment cost, and the source of financing for a sustainable National Health Insurance Scheme.

The COVID pandemic has undoubtedly impacted the socio-economic structure of our country and in health services exposed significant gaps in the continuity of care. Now more than ever, it is imperative that a sustainable financing option be guaranteed for the welfare of most valuable resource; our population.