In our 4th priority setting exercise we invited 54 stakeholders by email, telephone calls and paper letters at least 21 days prior to the priority-setting meeting. We received 30 attendees in this fourth priority setting meeting from workers unions, professional associations, health service providers, health related government departments, consumer advocacy groups and non-governmental organizations. Participants were represented from 19 organizations/institutes as shown below.

• National Social Security Fund (NSSF)
• Kampala City Council Authority (KCCA)
• Uganda Nurses and Midwives Council (UNMC)
• Uganda National Health Consumers Organization (UNHCO)
• National Organization of Trade Unions (NOTU)
• Confederation of Free Trade Unions (COFTU)
• Uganda Manufacturers Association (UMA)
• Federation of Uganda Employers (FUE)1-Uganda Medical Association (UMA),
• Uganda Dental Association (UDA),
• Pharmaceutical Society of Uganda (PSU) 4-Uganda Private Medical Practitioners Association (UPMPA)1-African Air Rescue (AAR),
• Uganda Community Based Health Financing Association (UCBHFA),
• Health Partners Uganda (HPU)1-Uganda Catholic Medical Bureau (UCMB)
• Uganda Protestant Medical Bureau (UPMB)
• Uganda Muslim Medical Bureau (UMMB)
• St. Stephen’s Nsambya Hospital Kampala
• Kisubi Hospital Wakiso
• Doctor’s Clinic Seguku Wakiso.
• Uganda Health Care Federation (UHCF)
• Bugolobi Medical Centre (BMC)1-International Health Sciences University (IHSU)
• Makerere University (MakCHS, Department of Family Medicine and Child Health Development Centre)

We developed a priority setting strategy with the technical input from Prof. Fadi El Jardali and his team at the Center for Systematic Reviews in Health Policy & Systems Research (SPARK), American University of Beirut (AUB), Lebanon. SPARK has extensive experience in priority setting. We developed a protocol a priori, and worksheets based on guidance for conducting Delphi surveys. We presented participants with a set of documents constituting:

(a) The National Health Insurance Scheme Bill 2012;

(b) a background document outlining the context of the National Health Insurance Scheme in Uganda and clearly state the purpose of this priority setting meeting.

During the 4th priority setting meeting we conducted two face-to-face iterations of ranking, and the third was conducted online as a follow up. The key concerns are about the:

(a) – Governance of the scheme and accountability to the public

(b) – Mode and payment rates to health service providers

(c) – Costing of the health services in Uganda not done

(d) – Accreditation to facilitate quality health care services

(e) – Additional taxation to the formal employees, at 8% of gross salary