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National health insurance in Asia and Africa
There is widespread consensus that providing universal, sustainable, affordable and quality health services underpins efforts to achieve equitable health outcomes. UNICEF in 2010-2011 conducted a two-phase landscape analysis, funded by the Rockefeller Foundation, to investigate how health insurance and other social health protection mechanisms contribute to achieving universal health coverage (UHC). The work built on previous research examining the protection from impoverishment that health insurance provides to vulnerable groups, the potential for increasing and expanding insurance coverage, and the options for and constraints limiting the use of insurance to attain UHC.
The first phase of the landscape analysis (LA) sought to establish a baseline of information on health protection schemes for mothers, children and other vulnerablegroups, with a specific emphasis on assessing how national health insurance plans in Africa and Asia were contributing to achievement of UHC. In this phase the principal investigators issued a questionnaire to 72 UNICEF country offices, conducted an extensive global literature review, and carried out interviews with national and international experts. The second phase was comprised of nine case studies supplemented by additional literature reviews to identify how countries were using insurance to reduce financial barriers and provide protection against the consequences of ill health. UNICEF is applying the findings of the LA to inform other areas of work, such as its new Social Protection Framework to guide country programming; its efforts to strengthen sub-national capacity to recognise and remove access-barriers; and its support for the global strategic equity agenda.