In 1998, the Government of Belize outlined its Health Sector Reform Program under which it signaled health financing as one of three priority areas. As part of the reform implementation, the
National Health Insurance (NHI) was established in 2001 which had as its goal to improve access to quality of health services through both public and private sector providers as well as provide
an appropriate pooling mechanism that would decrease the amount that individuals were paying out of pocket for health care services. Fifteen years later, the Government of Belize is interested
in assessing to what extent NHI has had an effect on health outcomes, outputs, and access; quality in outputs and processes; and efficiency. This assessment lays out the results from the
assessment. On health outcomes, outputs, and access, the study found no difference in health outcomes, mixed results on health services outputs in NHI-contracted compared to non NHI-contracted
Primary Care Providers (PCPs), initial improvements in access to care, but little difference in addressing financial barriers to access. On the quality of outputs and processes, the quality of
NHI-contracted PCP services has improved over the years of NHI contracting. On efficiency, a simple efficiency analysis based on quality scores indicates that there is little difference between
Belize City South Side and Southern Region PCPs. However, while NHI chose to provide services in the lower income South Side of Belize City and the rural Southern Region as a way to target the
poor, membership registration has been on a first-come first-served basis rather than favoring the poorer within these geographical locations.These assessments provide the Government with the
evidence to guide their decision-making on whether NHI is a sustainable model and whether it should be scaled up on a national level. The report includes a set of policy considerations and
recommendations for the Government to review in light of the national discussions on NHI sustainability and scalability.
