Systematic Review of Literatures on Community-Based Health Insurance: Experiences from Developing Countries

Abstract

Access to healthcare services are an essential for maintaining and improving health of citizen. Good health is a key to sustained economic, social development and poverty reduction. Universal health coverage means that all people have equitable access to health services, improved quality of health services, and financial-risk protection. Community Based Health Insurance (CBHI) schemes are expected as a transitional mechanism to achieving universal coverage for health care in developing countries. CBHI schemes are characterized as hybrid arrangement from both traditional risk-sharing and formal health insurance policies. CBHI schemes are built upon the principles of social solidarity and common benefits to provide financial protection against medical expenses. To assess the ability of such schemes in meeting objectives of UHC, this study aims to systematically reviews of the existing theoretical literatures and empirical evidence on three outcomes; conceptual definition, characteristics of the scheme, and challenges to the success of the community based health insurance in developing counties. The study employed a qualitative research methodology by applying the basic principles of a systematic review in order to assess the existing literatures on the effectiveness and challenges of CBHI schemes in developing countries. This study totally relies on secondary sources which were collected from published works on journals, newspapers, published and unpublished articles of credible and reliable online sources. The review of literatures shows that the major challenges of the schemes are adverse selection, limited risk pool, poor financial risk protection, lack availability and quality of services, and lack of professional and standardized management. To overcome the challenges, all possible solutions were recommended.

Keywords: Community-based health insurance, Universal health coverage, Rural, Informal sector, Challenges, Effectiveness, Healthcare Financing

DOI: 10.7176/JESD/11-21-03

Publication date: November 30^th 2020