ORIGINAL RESEARCH article
Front. Health Serv.
Sec. Health System Economics and Financing
Acceptability of mobile money-based health insurance among people living with HIV and hypertension or diabetes in Uganda
Henry Zakumumpa 1
Richard Ssempala 2
Jepchirchir Kiplagat 3
Kwiringira Japheth 4
Wilm Quentin 5
Verena Struckmann 6
1. Makerere University, Kampala, Uganda
2. Makerere University, School of Economics, Kampala, Uganda
3. Moi University, Eldoret, Kenya
4. Kyambogo University, Kampala, Uganda
5. Universitat Bayreuth, Bayreuth, Germany
6. Technische Universitat Berlin, Berlin, Germany
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Abstract
ABSTRACT Background Although digital technologies are recognized as a promising alternative pathway for financing universal health coverage in sub-Saharan Africa (SSA), there exists little evidence on the acceptability of digital technologies for health financing by the informal sector in SSA. We sought to explore the perspectives of people with HIV (PWH) living with hypertension or diabetes on the acceptability of mobile money-based private health insurance in terms of potential facilitators and barriers to uptake in Uganda. Methods We conducted a qualitative exploratory study in Fort Portal City in mid-western Uganda. We conducted four focus groups with PWH (48 participants). We conducted 18 Key Informant Interviews with representatives of telecom companies and private health insurance companies and officials from Uganda Communications Commission. Data were analyzed by thematic approach. Results Our study provides unique in-depth accounts by PWH of increasing out-of-pocket expenditure while seeking care for the management of hypertension and diabetes relative to their HIV treatment. We identified potential facilitators to uptake of mobile money-based health insurance which include prior experience with mobile money health insurance, high mobile phone ownership, availability of mobile money-based health insurance products, perceived affordability of a monthly monetary deduction towards health insurance ($ 1.35 - $8.20) and perceptions that mobile money health insurance is easy to use and more convenient than conventional private health insurance. On the other hand, we found several potential barriers which include low awareness of insurance principles, the high cost of internet data in Uganda, mistrust in private insurance actors in Uganda, fears of fraud in mobile money transactions and intermittent electricity supply. Conclusion Overall, PWH and officials from telecom companies perceived a monthly mobile money deduction towards health insurance as affordable and acceptable to PWH living with hypertension or diabetes. However, mistrust of insurance companies and limited awareness of the principles of insurance pose a major barrier to uptake. Our findings suggest that mobile money-based health insurance is worthy of further research as a pathway to expanding health insurance coverage in Uganda and similar settings.
Summary
Keywords
Digital Health, digital technologies, Health financing, health insurance, mobilemoney, Uganda, Universal Health Coverage
Received
09 January 2026
Accepted
18 February 2026
Copyright
© 2026 Zakumumpa, Ssempala, Kiplagat, Japheth, Quentin and Struckmann. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Henry Zakumumpa
Disclaimer
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