Stakeholders’ Perceptions Towards the Anticipated Introduction of the National Health Insurance Scheme in Malawi

Introduction: Malawi through the Health Sector Strategic Plan III aims to introduce a National Health Insurance Scheme (NHIS) that will serve as a key health-financing mechanism for achieving Universal Health Coverage (UHC). Implementing the NHIS plays a crucial role in advancing toward UHC and has the potential to strengthen health systems. This study aimed to explore stakeholders' perceptions regarding the anticipated introduction of the NHIS in Malawi. Methods The study employed an exploratory qualitative study design. A purposive sampling technique was used to select 20 participants who were involved in in-depth interviews. All the interviews were recorded and transcribed verbatim. Data was analyzed using thematic content analysis with NVIVO software. Results The study findings revealed that most participants demonstrated knowledge of the NHIS and its benefits to Malawi. Generally, the findings showed that the anticipated NHIS aligned with the participant’s positive expectations and was seen as a critical step towards making advancement in efforts to generate domestic health funding and lessen the reliance on foreign donor assistance, and enhance self-sufficiency in addressing the healthcare needs of people in Malawi. However, the study identified several challenges to the feasibility of implementing the NHIS in Malawi, including a weak economy, stakeholder conflicts of interest, contradictory regulations and policies, and insufficient stakeholder engagement. Additional barriers include political obstacles, corruption, insufficient human resources, inadequate technology infrastructure, high poverty and low literacy levels, pervasive myths/misconceptions, community resistance, and reliance on free public health services. These challenges complicate the establishment, implementation, and sustainability of the NHIS. Conclusion These findings will help to build momentum and consensus for the readiness and willingness among diverse stakeholders, prompting the government to prioritize and invest in NHIS to strengthen the health system. They also highlight that the introduction of NHIS relies on intricate factors in the policy making process, aiding policymakers and stakeholders in making informed decisions.