of its beneficiaries and to improve efficiency by purchasing care from local
contracted units, typically a district health system network. Thus, the NHSO required
all contracted hospitals to set up one primary care unit for every 10,000-15,000
registered beneficiaries. In a typical rural area, the contracted hospital is a district
hospital serving a population of 50,000 (as described in Chapter 2) and can have
up to five primary care units. The whole district provider network is known as the
“contracting unit for primary care” or CUP. The CUPs deliver primary-care services
and arrange the referral of patients to secondary and tertiary-care services.
UCS members are automatically assigned to a CUP linked to their local district
hospital (based on their address as specified in their house registration document)
and therefore have little or no choice of provider, especially in rural areas where
almost all district hospitals are owned by the MOPH and all MOPH hospitals and
primary care units are obliged to contract with the NHSO.