Health Insurance Handbook : How to Make It Work

Abstract

Many countries that subscribe to the
 Millennium Development Goals (MDGs) have committed to
 ensuring access to basic health services for their citizens.
 Health insurance has been considered and promoted as the
 major financing mechanism to improve access to health
 services, as well as to provide financial risk protection.
 In Africa, several countries have already spent scarce time,
 money, and effort on health insurance initiatives. Ethiopia,
 Ghana, Kenya, Nigeria, Rwanda, and Tanzania are just a few
 of them. However, many of these schemes, both public and
 private, cover only a small proportion of the population,
 with the poor less likely to be covered. In fact, unless
 carefully designed to be pro-poor, health insurance can
 widen inequity as higher income groups are more likely to be
 insured and use health care services, taking advantage of
 their insurance coverage. The purpose of this handbook is to
 provide policy makers and health insurance designers with
 practical, action-oriented support that will deepen their
 understanding of health insurance concepts, help them
 identify design and implementation challenges, and define
 realistic steps for the development and scaling up of
 equitable, efficient, and sustainable health insurance
 schemes. The handbook takes policy makers and health
 insurance designers through a step-by-step series of
 considerations and tasks that need to be achieved. The
 handbook's philosophy is to not be dogmatic,
 ideological, or prescriptive. This handbook was prepared to
 be used in a six-day regional workshop. Clearly, health
 insurance design is an intensive political and technical
 process that takes much longer than six days. The
 expectation for the workshop is that by the end of the week,
 each team has a clear idea of next steps that they could
 take back home to engage other stakeholders and move toward
 scaling up and improving the performance of health insurance
 in their country.