Ishaka Health Plan (IHP) is a community based health insurance scheme which aims at improving access to quality and affordable healthcare services to low income earners in rural communities in Bushenyi district, Uganda. The scheme reduces out-of-pocket expenditure among its members through risk pooling and prepayment mechanisms. Previous studies have reported that about 16% and 27% of households in Uganda suffer from catastrophic health expenditure as a result of direct costs, and direct and indirect costs respectively. Although evidence has shown that community based health insurance schemes increase utilization of healthcare services and reduce catastrophic health spending, these schemes are affected by low membership and drop-outs which in turn results into reduced risk pooling.