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Health Insurance

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Challenge

Out-of-pocket (OOP) health spending by households accounts for more than half of total health financing in most developing countries in Asia and sub-Saharan Africa. Reducing OOP payments and developing appropriate financial risk protection systems is crucial to increasing access to health care by the poor and working towards the World Health Organization’s goal of universal coverage. Since the 2005 call for universal coverage, 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

Health Systems 20/20 has a solid foundation in the areas of health insurance, vouchers, conditional cash transfer, and other financial risk protection activities. The project has shown global leadership by helping countries develop and implement more effective financial risk protection mechanisms. The project’s approaches to these challenges include:

  • Increasing understanding among policymakers and implementers to the challenges as well as benefits of financial risk protection approaches based on the evidence from studies and regional workshops, and practical technical materials such as the Health Insurance Handbook
  • Providing country-based technical assistance to move forward with schemes development and implementation in Egypt, India, Liberia, Mali, and Senegal
  • Building the global leadership and the collaboration relationship with international development agencies to accelerate and expand the project’s technical impact, enhance project and USAID credibility, and leverage funds

Useful Resources

Eight Strategies that Strengthen Health Systems Worldwide

Nov 2011 | Health Systems 20/20  | Better Health Systems Briefs, Brief 

Health Systems 20/20 and Financial Risk Protection

Oct 2011 | Health Systems 20/20  | Brief 

Paying for a Healthier Future

Catherine Connor, Laurel Hatt, Thierry Van Bastelaer
Jun 2011 | Health Systems 20/20  | Journal 

The Health Insurance Organization of Egypt: Utilization and Case Management

Thomas Schwark and Mohsen George
Jun 2011 | Health Systems 20/20  | Presentation 
Egypt 

Health Financing in Low-Income Countries: The Liberia Case

Catherine Connor
Mar 2011 | Health Systems 20/20  | Presentation 
Liberia 

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The World Bank Reissues Health Systems 20/20 Health Insurance Handbook

Jan 6 2012

The World Bank has reissued the Health System 20/20 Health Insurance Handbook: How to Make it Work as part of the World Bank Working Paper series. Available in paper, widget, and e-book form, the reissue makes the handbook available to an even broader audience and furthers Health Systems 20/20 collaboration with the Bank.

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Setting Up a National Health Insurance Plan in Namibia

Oct 11 2011
Currently, only 16-18 percent of all Namibians receive medical aid and only 50 percent of the working population has medical insurance. In an effort to increase coverage, the University of Namibia, School of Medicine hosted a workshop where Health Systems 20/20 provided invaluable input into the development of a national health insurance plan. More...

Egypt’s National Health Insurance Organization Staff Receive Financial and Case Management Training

Jul 19 2011
This spring, over 100 staff from Egypt’s Health Insurance Organization (HIO) received training in the areas of utilization and case management and financial management. Staff will apply their newly acquired skills to help the HIO become an effective health care services payer and provider. The HIO is responsible for designing, pricing, negotiating, contracting, and paying for services covered under Egypt’s social health insurance scheme to ensure high-quality health care services for all Egyptians. More...

Working with Nigerian Policymakers to Share Lessons on National Health Insurance

Jul 14 2011
Health economist Dr. Hong Wang did not come to the “Expanding Coverage to the Informal Sector” workshop to share a chapter from his book—he came to empower others. National policymakers from 13 developing countries took center stage at the four-day workshop hosted by the Joint Learning Network for Universal Health Coverage (JLN), sharing accomplishments and challenges to providing health coverage to poor and informal sector populations. More...

Staff Present at International Health Economics Conference July 10-13

Jul 5 2011
Health Systems 20/20 staff shared insights on resource tracking, costing, and removing user fees at the 8th World Congress on Health Economics: Transforming Health & Economics in Toronto. The event was sponsored by the International Health Economics Association, which represents over 2,500 health economists in more than 75 countries. More...

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