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Health Insurance/Financial Risk Pooling

Challenge

Out-pocket spending by households – the most regressive form of financing and the most likely to impede access to health care by the poor – accounts for more than half of total health financing in most developing countries in Asia and Sub Saharan Africa. WHO passed a resolution in 2005 endorsing universal coverage. Since then interest in health insurance among developing countries has spread quickly. Almost every USAID-presence country in sub-Saharan Africa is actively exploring the introduction or expansion of some form of risk pooling. Worldwide, many countries already have spent scarce time, money, and effort on health insurance initiatives. While health insurance offers many benefits, developing countries face great challenges as to how to increase their financing capacity, extend health insurance coverage to the poor, expand benefits packages, and improve the performance of existing health insurance schemes.

Approach

In response to these trends, Health Systems 2020’s strategy for health insurance is to move countries along a transparent and responsible path towards universal health insurance coverage/financial risk protection in a sustainable manner. The project’s philosophy is to support country-led design and implementation based on evidence, avoiding dogma and generic prescriptions. Health Systems 20/20 is working to:

  • Increase the understanding among policymakers and implementers to the challenges as well as benefits of these approaches based on the evidence (studies, regional workshops, and practical technical materials such as the Health Insurance Blueprint Guide)
  • Assist countries move forward with implementation (India, Liberia)
  • Collaborate with international partners (World Bank, WHO, ILO, Results for Development, The Gates Foundation, ECSA-HC)


Download Health Systems 20/20 and Health Financing Brief

Find information about the Ghana Africa Health Insurance Workshop and planned Francophone Health Insurance Workshop

Download a Health Systems 20/20 presentation on improving access to health care through insurance

Health Systems 20/20 Year 3 Annual Report

Dec 8 2009, Health Systems 20/20
Project: Health Systems 20/20
Type: Report

Tracking Development Assistance for Health

Nov 24 2009, Nirmala Ravishankar
Project: Health Systems 20/20
Type: Presentation

Training course on quality standards

Oct 20 2009, Al Gomhuria Online
Project: Health Systems 20/20
Type: Web Site
Country: Egypt

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Health Insurance Workshop, October 2009, Ghana

Jul 8 2009

Many African countries are interested in health insurance and are experimenting with different forms of risk pooling. Health Systems 20/20, in coordination with the World Bank and WHO, is organizing a hands-on workshop to help countries chart an informed and responsible path towards a form of health insurance that fits their needs and resources.

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Survey on Using "Pay for Performance" to Improve Health Outcomes in Developing Countries

May 7 2009

Does your program use pay-for-performance (P4P) to improve health outcomes? Or are you familiar with such programs? If so, we would appreciate your input.

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New Brief: National Health Accounts and Public Expenditure Reviews: Redundant or Complementary Tools?

Mar 11 2009

Government and donor promotion of both National Health Accounts (NHA) and Public Expenditure Reviews (PER) raises the question, Is there a need to conduct NHA in countries that are undertaking PER and vice versa, or are these tools redundant?

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Health Systems 20/20 Releases Year 2 Annual Report

Dec 31 2008

Read about project activities in Year 2 to increase the use of priority population, health, and nutrition services, especially by the disadvantaged through improvements in health financing, governance, operations, and capacity building.

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Innovations for Health Financing in Sub-Saharan Africa

Dec 30 2008

Senior experts from development agencies and think tanks located in the Washington area met on November 5, 2008 for a roundtable discussion on "Innovations for Health Financing in Sub-Saharan Africa."

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