Health insurance scheme isn’t inclusive in design, implementation – ZCTU


ZAMBIA is facing a challenge at the design stage of social protection schemes, says Zambia Congress of Trade Unions president Chishimba Nkole.


In a presentation to the plenary of the 108th session of the International Labour Conference in Geneva, Switzerland, Nkole said the health insurance scheme, whose objective was to provide universal health coverage, does not meet the basic tenets of being an inclusive scheme in design and implementation.

He said the importance of attaining universal social protection needed to be emphasized, especially in most developing countries in Africa and Zambia in particular where the majority of workers were in the informal economy.

“In light of this, we wish to mention that currently Zambia is undergoing social protection reforms. However, we face a challenge at the design stage of our social protection schemes where the health insurance scheme, whose objective is to provide universal health coverage, does not meet the basic tenets of being an inclusive scheme in design and implementation,” he said.

Nkole said the Ministry of Health under which the scheme was established excluded most representative workers and employers’ organisations from participating in the scheme’s design and implementation.

He said among other things, the scheme risked excluding the majority of workers, especially thosein the informal economy.

Nkole said while the Ministry of Labour agreed with the social partners to integrate the health insurance scheme into the broader social protection scheme to reduce on administrative costs, the Ministry of Health arrogantly undermined this tripartite consensus and established the scheme under it without involvement of social partners and other key stakeholders.

“In general, lessons from Zambia can show that the absence of institutional collaboration at national level can result in policy incoherence and exclusion and generally undermine the principle of tripartism,” he said.

Nkole said the report of the ILO Global Commission on the Future of Work details how to achieve a better future of work for all at a time of unprecedented change and exceptional challenges in the world of work.

“We are glad that the report brings to light the need to pursue a human centred development agenda with emphasis, among other things, on lifelong learning, greater inclusivity, gender equality, and the role of universal social protection in a stable and just future of work,” Nkole said.

“It is true that none of this will happen by itself without decisive action. This calls for stronger partnerships at global level and institutional coherence with strengthened collaboration at national level to ensure greater inclusivity and equality.”

Nkole called for stronger collaboration among development agencies at global level to ensure policy coherence and inclusion at national level.

“We also call for capacity building particularly towards achieving the UN Global Agenda 2030 for sustainable development, which is consistent with ILO’s aspirations of establishing universal social protection floors at national level,” he said.

“As we commemorate and celebrate ILO’s 100 years of existence, we also envisage an ILO that is inclusive and democratic in design and practice. For this reason, we support the calls to restructure the Governing Body of the ILO to make it more inclusive and democratic.”


Nkole said the ILO Centenary Declaration should take into account the need to ensure that in the next 100 years, ILO would endeavour to pursue equality by ensuring equal participation of member states in decision making as well as ensuring equal participation of men and women in all ILO structures.

“As regards the work of the Committee on Ending Violence and Harassment at the place of work, we are glad to see that all tripartite constituents are resolved to formulate a convention that would reflect the need to address the underlying causes of violence and harassment in workplaces notwithstanding our cultural and regional diversity,” said Nkole.

“In conclusion, we wish to underscore the need for capacity building for workers’ organizations and indeed all ILO constituents in order to continuously align ourselves with the strategic objectives of the ILO. All in all, we reaffirm our commitment to the founding principles of the ILO as we adopt the Centenary Declaration.”

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