Social Health Insurance |
|||||||||||
Description | Key Features |
||||||||||
Systems with publicly mandated coverage for designated groups, financed through payroll contributions, semi-autonomous administration, care provided through own, public, or private facilities |
|
||||||||||
Strengths |
Weaknesses | ||||||||||
|
|
||||||||||
Case Examples | |||||||||||
Community-based Health Insurance
|
|||||||||||
Description | Key Features |
||||||||||
Not-for-profit prepayment plans for health care, with community control and voluntary membership, care generally provided through NGO or private facilities |
|
||||||||||
Strengths |
Weaknesses | ||||||||||
|
|
||||||||||
Case Examples | |||||||||||
|
Voluntary Health Insurance
|
|||||||||||
Description | Key Features |
||||||||||
Financed through private voluntary contributions to for- and non-profit insurance organizations, care provided in private and public facilities |
|
||||||||||
Strengths |
Weaknesses | ||||||||||
|
|
||||||||||
Case Examples | |||||||||||
|
Out-of-Pocket Payments (including public user fees)
|
|||||||||||
Description | Key Features |
||||||||||
Fees for publicly provided services |
|
||||||||||
Strengths |
Weaknesses | ||||||||||
|
|
||||||||||
Case Examples | |||||||||||
|
Gargasson and Salome. The Role of Innovative Financing Mechanisms for Health. World Health Report 2010. Background Paper, 12. PDF
The article uses Taskforce Working Group 2's definition of innovative financing mechanisms as "non-traditional application of ODA, joint public-private mechanisms, and flows that either support fundraising by tapping new resources or delivery financial solutions to development problems on the ground" (Taskforce Working Group 2, 2009). The authors note the main role of such mechanisms is "to fill the existing financial gap," estimated to be around US$36-45 billion, to achieve MDGs. The mechanisms used by the Global Fund, the GAVI Alliance and UNITAID are deemed to have been successful examples that have resulted in significant expansion of their activities.
Community-based health insurance in low income countries: A systematic review of the evidence. Health Policy Plan. (2004) 19 (5):249-270. http:\\doi: 10.1093/heapol/czh031 PDF
ABSTRACT: Health policy makers are faced with competing alternatives, and for systems of health care financing. The choice of financing method should mobilize resources for health care and provide financial protection. This review systematically assesses the evidence of the extent to which community-based health insurance is a viable option for low-income countries in mobilizing resources and providing financial protection. The review contributes to the literature on health financing by extending and qualifying existing knowledge. Overall, the evidence base is limited in scope and questionable in quality. There is strong evidence that community-based health insurance provides some financial protection by reducing out-of-pocket spending. There is evidence of moderate strength that such schemes improve cost-recovery. There is weak or no evidence that schemes have an effect on the quality of care or the efficiency with which care is produced. In absolute terms, the effects are small and schemes serve only a limited section of the population. The main policy implication of the review is that these types of community financing arrangements are, at best, complementary to other more effective systems of health financing. To improve reliability and validity of the evidence base, analysts should agree on a more coherent set of outcome indicators and a more consistent assessment of these indicators. Policy makers need to be better informed as to both the costs and the benefits of implementing various financing options. The current evidence base on community-based health insurance is mute on this point.