The Essential Package of Health Services and Health Benefit Plans in Haiti is a policy framework that identifies the essential health services prioritized by the government. The government aims to ensure that these services reach the population equitably. A health benefit plan specifies an explicit set of services and the cost-sharing requirements for beneficiaries to access those services.
In 2015, the USAID-funded Health Finance and Governance (HFG) project completed a landscape analysis of the Essential Package of Health Services (EPHS) in 24 USAID priority countries for Ending Preventable Child and Maternal Deaths (EPCMD). The analysis found that most governments intend for public and/or private not-for-profit facilities to deliver the services in the EPHS. Several governments were implementing major health benefit plans (HBPs) as a primary strategy for moving toward universal health coverage.
The HFG project conducted a second landscape analysis in 2016 to identify existing HBPs in the countries and the services they cover. A crosswalk analysis was performed to map the services specified in the country’s EPHS to those identified in an HBP. This analysis documented the degree of alignment between the EPHS and HBP.
The Civil Servants’ Self-Insurance Program is a health benefit plan implemented by the government in 2000. The program is funded half from the national budget and half through payroll taxes. Membership is mandatory for civil servants, who are automatically enrolled in the scheme. Civil servants and their employers jointly contribute 6 percent of the employee’s salary as a premium. Members pay a 50 gourdes (US $0.75) copayment to access services at a network facility.
The program covers a range of services, including pharmaceuticals, radiology, laboratory tests, outpatient services, dermatology, urology, ophthalmology, radiotherapy, and ambulatory services. However, HFG did not identify a detailed list of services covered by the Civil Servants’ Self-Insurance Program, and therefore could not perform a corresponding crosswalk analysis.
Konbit Solidarity is a health insurance program implemented by the government in 2014. The program provides coverage to the formal and informal sector. Membership is mandatory for formal workers and voluntary for informal workers. Formal sector workers and their employers jointly pay a payroll tax equal to 6 percent of the employee’s salary. Informal workers contribute 100 gourdes (US $1.50) per month, and the government pays a subsidy of 600 gourdes (US $9) per person per year into the scheme.
Konbit Solidarity covers a range of services, including general care, specialized care, surgery, antenatal, delivery, and postnatal care, care related to hospitalization and surgery, laboratory tests, X-rays and medical imaging, organ function tests, medications, pharmaceutical products, and other consumables administered during direct treatments and admissions, blood bags, physical rehabilitation, transfer of urgent cases to a referral facility, hypertension, and diabetes. However, HFG did not identify a detailed list of services covered by the Konbit Solidarity scheme, and therefore could not perform a corresponding crosswalk analysis.
The Essential Package of Health Services and Health Benefit Plans in Haiti is a policy framework that aims to ensure that essential health services reach the population equitably. The government has implemented several health benefit plans, including the Civil Servants’ Self-Insurance Program and Konbit Solidarity. These plans cover a range of services, including pharmaceuticals, radiology, laboratory tests, outpatient services, and hospitalization. However, there is a need for further analysis to determine the degree of alignment between the EPHS and HBP.