Community Based Health Insurance Schemes (CBHIs) in Health Care Financing: Review of Experiences of the Asian and African EconomiesAuthor : Paramita Roy and Asok Kumar Sarkar
Volume 7 No.3 October-December 2018 pp 63-68
The WHO World Health Assembly and the World Health Report (2010) have called for all health systems to move towards universal health coverage. This is a challenge for the resource-scarce low and middle income countries. Health related expenses remain the most important reason for households being pushed below poverty line (Xu et al; 2003, 2007). One alternative to covering poor people in the informal sector is to involve them into Community Based Health Insurance Schemes (CBHIs). Scholars and practitioners have expended substantial effort on investigating the effectiveness and sustainability of CBHIs, the challenges faced by them, the solutions for improvement and the potential role of the CBHI in a national financing strategy to achieve universal coverage in low income countries. The present paper first describes the development of CBHIs through an evolutionary perspective and then highlights the significant factors essential to integrate the CBHI into the national financing strategy (Bennett, 2004;Wang and Pielemeier, 2012). Using this framework, the second section undertakes a review of CBHIs in selected countries in Asia and Africa to identify key contributing and/or challenging factors faced by CBHIs in each stage. The study provides recommendations on how to adopt characteristics to transform fragmented CBHI initiatives towards achieving universal coverage.
CBHIs, community health insurance, health care in Asia and Africa, health insurance, community financing
 Ahuja R. and Jutting J. (2003), Design of Incentives in Community based health insurance schemes, Working Paper No. 95, Indian Council for Research in International Economic Relations.
 Bennett, S. (2004). The role of community-based health insurance within the health care financing system: a framework for analysis, Health Policy and Planning 19(3): 147-158.
 Carrin, G. Waelkens, M. And Criel, B. (2005), Community-based health insurance in developing countries: aastudy of its contribution to the performance of health systems, Tropical Medicine and International Health, 10(8), 799-811.
 Devadasan N. (2006), Community based health insurance in India: A compilation of case studies, FWWB, Ahmedabad.
 ILO, (2005), Community Based Schemes-India: An Inventory of Micro Insurance Schemes, Geneva.
 McCord, M. and Osinde, S. (2003), Reducing Vulnerability: the Supply of Health Microinsurance in East Africa. A Synthesis Report. MicroSave-Africa, Nairobi. http://www.MicroSave-Africa.com.
 Purohit, B. (2014) Community Based Health Insurance in India: Prospects and Challenges. Health, 6, 1237-1245. http://dx.doi.org/10.4236/health.2014.611152.
 USAID (2013). Building on Community-based health insurance to expand national coverage: The case of Ghana,Geneva.
 van den Heever, A. (1997), Regulating the funding of private health care: the South African experience. In: Private Health Providers in
Developing Countries, Ch. 10 (eds S Bennett, B McPake& A Mills) Zed Books, London, 158–173.
 vanGinneken, W. (ed.) (1999), Social Security for the Excluded Majority – Case Studies of Developing Countries. International Labour Office, Geneva.
 Wang, H. and Pielemeier, N., (2012). Community-Based Health Insurance: An Evolutionary Approach to Achieving Universal Coverage in Low-Income Countries, Journal of Life Sciences 6: 320-329.
 Would Health Organization, (WHO). (2010). Health Systems Financing: The Path to Universal Coverage, Geneva.
 World Health Organisation (WHO) (2014). Country Cooperation Strategy- Ghana, Geneva.
 Xu, et al. (2003). Household catastrophic health expenditure: A multicountry analysis, Lancet, 362, 111-117.