Impact of national health insurance for the poor and the informal sector in low- and middle-income countries: a systematic review
Acharya, Arnab, Sukumar Vellakkal, Fiona Taylor, Edoardo Masset, Ambika Satija, Margaret Burke and Shah Ebrahim.
July, 2012
EPPI-Centre, Social Science Research Unit, Institute of Education, University of London
Publication Type:
Research Paper

Abstract: Moving away from out-of-pocket (OOP) payments for healthcare at the time of use to prepayment through health insurance (HI) is an important step towards averting financial hardships associated with paying for health services. Social health insurance (SHI) is mandated for those employed in many developed countries where employment and wage rates are high; this service is extended to those unemployed through subsidy. In low- and middle-income countries (LMICs) some version of SHI has been offered to those in the informal labour sector, who may well comprise the majority of the workforce. We carried out a systematic review of studies reporting on the impact of health insurance schemes that are intended to benefit the poor, mostly employed in the informal sector, in LMICs at a national level, or have the potential to be scaled up to be delivered to a large population.

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