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General Objective:
·
Providing medical
services for citizens without financial or geographical
impediments, with high quality as well as raising coverage
from 27% to 100%in three years time.
Specific Objectives:-
·
Setting a system
that secures getting of medical services by citizens without
financial impediments.
·
Contributing in
health development.
·
Guaranteeing the
quality of services provided by medical institutions as well
as promoting and developing them.
Guaranteeing the availability of medical services close to
the citizen houses locations.
·
At individuals’
level, medical treatment constitutes a worry for most
citizens and many obstacles face the integration of all
citizens of which is related to behavior, conduct of the
individual, some are related to personal income and some is
related with institutions to integrate all community
segments under the base of medical insurance. Therefore, the
Comprehensive Medical Insurance Coverage Project for All
Khartoum State’s Citizens to be introduced through:
1-
Semi regular sector ( trade
unions, associations , organizations ….etc)
2-
Housing Zones (families –
individuals.)
·
Medical insurance
system is a joint liability system in which the subscriber
pays according to his income to receive medical service and
medication according to his and family members needs.
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1- Semi
Regular Sector:
There are
enrolled according to segment and the body organizing it,
such as union, organization trade union or market committee
for example. Profession exercise and the licenses thereof
can be linked with joining medical insurance.
2-
Housing Zones:-
They are
integrated by making a survey for the localities by
population census. This survey specifies the targeted
sectors and the sectors that can be covered by other
systems.
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· Population
Number = 6,000,000 persons
· Bodies
of Special Services
· (Regular
Forces and other) = 1,250,000
persons
· Medical
Insurance Targeted Number = 4,750,000 persons
·
No of
medical insurance targeted families
(Average per family: 5
persons) = 950,000 families
These targeted
families are divided into three groups:
·
Families
of good living conditions and can fully pay the
insurance subscription. They constitute 15% (142,500
families).
·
Families
of middle income. They need medical insurance and
can contribute in the service cost. They constitute
50% (475,000 families)
·
Poor
Families: they need insurance and can no contribute
in the service cost. They constitute 35% (332,500
families)
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For implementing the
goal of Medical Insurance comprehensive Coverage,
the number of targeted families is (690,000)
distributed as follows:
·
Good-income families. Their number is ( 142,500
families)
·
Middle-income families. Their number is (475,000
families)
(Insurance currently
covers (237,000 families)
·
Poor
families. Their number is (332,500 families)
(Insurance currently covers 23,000 families) |
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·
Compulsory
subscription for all the citizens in Khartoum State. That
shall be in public, private and self-employed sectors.
·
Employees of
public and private sectors shall be entered through their
institutions.
·
Employees of
self-employed sector who do not have regular wage or
specific employer shall be entered through localities and
popular committees.
·
Employees in
non-regular sector who do not have regular wage nor specific
employer but they are members of an association, trade union
or organization such as (tradesmen, mini bus drivers, and
merchants ….etc) are entered through their trade union
organizations.
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·
Political
commitment of the state represented in paying the
required amount annually.
·
Issuance
of an Act that immediately makes medical insurance
compulsory for all the citizens of the Khartoum
State (KS) and keenness for its implementation as
well as linking medical insurance card with some
procedures in the country (such as ; work) after the
end of five years. Political commitment by the
mayors in propagation and motivation of the
irregular community complexes to enter into medical
insurance program.
·
Commitment by the KS to rehabilitate medical
institutions periodically as well as covering the
shortage therein during the period.
·
Activating medical insurance mechanisms in the KS
for entering these groups.
·
Commitment by the Ministry of Health to strictly
control medical units as well as guaranteeing the
presence of medical frameworks therein besides good
quality of provided services.
·
The
medical insurance should make contracts with
government and private institutions besides
organizations during this period. The contract
condition should be obligation with required quality
and medical insurance prices.
·
Presence
of a rule for entering the medical institutions in
insurance program and sending out any unit not
complying with the required rules. |
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