News / Africa

Expanding Health Insurance in Developing Countries

Rwanda will host regional conference on health insurance.Rwanda will host regional conference on health insurance.
x
Rwanda will host regional conference on health insurance.
Rwanda will host regional conference on health insurance.
Joe DeCapua
Rwanda will host a regional conference next week (9-11/13), with a focus on health insurance. Rwanda has been praised for moving toward universal coverage for its population. But many say it’s a complicated issue that does not have a one-size-fits-all solution.

The Conference on Social Health Protection in the East African Community will consider various approaches to providing universal health coverage in Rwanda, Uganda, Kenya, Tanzania and Burundi.

Universal coverage is the subject of a new study that reviewed health systems in 12 African and Asian countries.

The World Health Organization’s Joe Kutzin says universal coverage is more of a “direction than a destination.”

“What it means you want to move towards universal coverage, which means you want to improve access. You want to improve financial protection and you want to improve quality. And in that sense, those are goals for every country in the world. So it’s relevant to every African country, every European country, the U.S. and so on, to make progress towards those goals,” he said.

Kutzin is coordinator of health financing policy and analyzed the study published in the Bulletin of the World Health Organization.

Dr. Ernst Spaan, one of the authors, said, “There is a lot of debate going on on how to finance health services in developing countries. In Asia and Africa there is a lot of debate on should they focus on social health insurance or community-based health insurance? And we actually looked into that and we found out there are a lot of studies, but it’s a bit patchy. So we decided to do a systematic review of the literature.”

Spaan is a senior researcher and lecturer in public health at the Radboud University Nijmegen Medical Center in the Netherlands.

The study looked at what he calls impact indicators. These include the way financial resources are collected to fund insurance plans, the amount of coverage provided to recipients, whether that coverage is provided to all segments of society and whether there’s been an improvement in the quality of life.

It says social and community health insurance plans “hold untapped potential” for achieving universal coverage. But Spaan says for that to happen, funding issues need to be addressed. For example, he says social plans are generally mandatory and may be funded through payroll deductions.

“That of course poses a problem in many developing countries because of the fact that the informal sector is quite large. Sometimes even 60 percent of the population or higher is not in formal employment. Also because of the large agricultural sector income is dependent on harvest times, so it’s also very erratic,” said Spaan.

WHO’s Kutzin said some insurance systems may also require a user fee that’s paid at the time of medical services.

“When people have to pay a lot at the time they use services it poses a real, severe economic risk to their households. Very often you find cases where, for example, people have to sell off their assets, whether that is in cash or in animals.  Whatever may be the main source of wealth, people are selling off their assets in order to raise the money to pay for care,” he said.

Spaan and his colleagues also looked at community insurance plans.

“These are organized, generally, on a smaller scale. And in many countries you find these schemes are linked to, for instance, one hospital or even to a school. So they insure school children, for instance, or they insure the people around a certain health facility. But what is more important is that it’s a certain scheme where the local population is more involved in the set-up of the scheme. And least that’s the ideal,” said Spaan.

He added that the study’s findings “back the World Health Organization’s view that pre-paid financing mechanisms, such as health insurance, are a key route to universal coverage.”

But Kutzin said there are many ways to provide health coverage besides those presented in the study.

“One of the best known cases we have is from Thailand, which in 2002 instituted a program called the Universal Health Coverage Scheme. It’s neither community-based nor is it contributory. It is a system where the government using general tax revenues puts all of that money into a single pool. And anyone is entitled to sign-up for the program. They don’t have to contribute anything. That pool pays for services on behalf of the entire population,” he said.

He said Rwanda uses a multiple funding approach for its mandatory health coverage, including general tax revenues and donor funding. And it uses its community-based systems in a coordinated way.

Universal health coverage has been a controversial topic here in the United States, but not in many other countries. Kutzin said that’s because there has not been a clear discussion about what universal coverage is trying to achieve. He says the main question is whether two people, one rich and one poor, with the same medical condition, have access to the same treatment?

You May Like

Ukraine: Mysterious 'Roaming Tank' Reportedly Takes Aim at Smugglers

Ukraine's TV, print media, Facebook abuzz with reports a 'roaming tank' is on the loose, destroying vehicles of those involved in smuggling More

US Wildlife Service Begins Probe of Killing of Cecil the Lion

Minnesota man accused of killing beast is in hiding, has been asked to contact US officials; White House to review extradition petition More

Video Kerry Tour Will Cover Security, Iran Nuclear Deal

US secretary of state to visit 5 countries in the Middle East, South Asia in bid to strengthen economic and security ties, ease concerns over deal with Tehran More

Featured Videos

Your JavaScript is turned off or you have an old version of Adobe's Flash Player. Get the latest Flash player.
Booming London Property a ‘Haven for Dirty Money’i
X
July 29, 2015 9:34 PM
Billions of dollars of so-called ‘dirty money’ from the proceeds of crime - especially from Russia - are being laundered through the London property market, according to anti-corruption activists. As Henry Ridgwell reports from the British capital, the government has pledged to crack down on the practice.
Video

Video Booming London Property a ‘Haven for Dirty Money’

Billions of dollars of so-called ‘dirty money’ from the proceeds of crime - especially from Russia - are being laundered through the London property market, according to anti-corruption activists. As Henry Ridgwell reports from the British capital, the government has pledged to crack down on the practice.
Video

Video Hometown of Boy Scouts of America Founder Reacts to Gay Leader Decision

Ottawa, Illinois, is the hometown of W.D. Boyce, who founded the Boy Scouts of America in 1910. In Ottawa, where Scouting remains an important part of the legacy of the community, the end of the organization's ban on openly gay adult leaders was seen as inevitable. VOA's Kane Farabaugh reports.
Video

Video 'Metal Muscles' Flex a New Bionic Hand

Artificial limbs, including the most complex of them – the human hand – are getting more life-like and useful due to constant advances in tiny hydraulic, pneumatic and electric motors called actuators. But now, as VOA’s George Putic reports, scientists in Germany say the future of the prosthetic hand may lie not in motors but in wires that can ‘remember’ their shape.
Video

Video Russia Accused of Abusing Interpol to Pursue Opponents

A British pro-democracy group has accused Russia of abusing the global law enforcement agency Interpol by requesting the arrest and extradition of political opponents. A new report by the group notes such requests can mean the accused are unable to travel and are often unable to open bank accounts. VOA's Henry Ridgwell reports.
Video

Video 'Positive Atmosphere' Points Toward TPP Trade Deal in Hawaii

Talks on a major new trade agreement among 12 Pacific Rim nations are said to be nearing completion in Hawaii. Some trade experts say the "positive atmosphere" at the discussions could mean a deal is within reach, but there is still hard bargaining to be done over many issues and products, including U.S. drugs and Japanese rice. VOA's Jim Randle reports.
Video

Video Genome Initiative Urgently Moves to Freeze DNA Before Species Go Extinct

Earth is in the midst of its sixth mass extinction. The last such event was caused by an asteroid 66 million years ago. It killed off the dinosaurs and practically everything else. So scientists are in a race against time to classify the estimated 11 million species alive today. So far only 2 million are described by science, and researchers are worried many will disappear before they even have a name. VOA’s Rosanne Skirble reports.
Video

Video Scientists: One-Dose Malaria Cure is Possible

Scientists have long been trying to develop an effective protection and cure for malaria - one of the deadliest diseases that affects people in tropical areas, especially children. As the World Health Organization announces plans to begin clinical trials of a promising new vaccine, scientists in South Africa report that they too are at an important threshold. George Putic reports, they are testing a compound that could be a single-dose cure for malaria.
Video

Video 'New York' Magazine Features 35 Cosby Accusers

The latest issue of 'New York' magazine features 35 women who say they were drugged and raped by film and television celebrity Bill Cosby. The women are aged from 44 to 80 and come from different walks of life and races. The magazine interviewed each of them separately, but Zlatica Hoke reports their stories are similar.
Video

Video US Calls Fight Against Human Trafficking a Must Win

The United States is promising not to give up its fight against what Secretary of State John Kerry calls the “scourge” of modern slavery. Officials released the country’s annual human trafficking report Monday – a report that’s being met with some criticism. VOA’s National Security correspondent Jeff Seldin has more from the State Department.
Video

Video Washington DC Underground Streetcar Station to Become Arts Venue

Abandoned more than 50 years ago, the underground streetcar station in Washington D.C.’s historic DuPont Circle district is about to be reborn. The plan calls for turning the spacious underground platforms - once meant to be a transportation hub, - into a unique space for art exhibitions, presentations, concerts and even a film set. Roman Mamonov has more from beneath the streets of the U.S. capital. Joy Wagner narrates his report.
Video

Video Europe’s Twin Crises Collide in Greece as Migrant Numbers Soar

Greece has replaced Italy as the main gateway for migrants into Europe, with more than 100,000 arrivals in the first six months of 2015. Many want to move further into Europe and escape Greece’s economic crisis, but they face widespread dangers on the journey overland through the Balkans. VOA's Henry Ridgwell reports.
Video

Video Stink Intensifies as Lebanon’s Trash Crisis Continues

After the closure of a major rubbish dump a week ago, the streets of Beirut are filling up with trash. Having failed to draw up a plan B, politicians are struggling to deal with the problem. John Owens has more for VOA from Beirut.
Video

Video Paris Rolls Out Blueprint to Fight Climate Change

A U.N. climate conference in December aims to produce an ambitious agreement to fight heat-trapping greenhouse gases. But many local governments are not waiting, and have drafted their own climate action plans. That’s the case with Paris — which is getting special attention, since it’s hosting the climate summit. Lisa Bryant takes a look for VOA at the transformation of the French capital into an eco-city.
Video

Video Racially Diverse Spider-Man Takes Center Stage

Whether it’s in a comic book or on the big screen, fans have always known the man behind the Spider-Man mask as Peter Parker. But that is changing, at least in the comic book world. Marvel Comics announced that a character called Miles Morales will replace Peter Parker as Spider-Man in a new comic book series. He is half Latino, half African American, and he is quite popular among comic book fans. Correspondent Elizabeth Lee reports from Los Angeles.
Video

Video Historic Symbol Is Theme of Vibrant New Show

A new exhibit in Washington is paying tribute to the American flag with a wide and eclectic selection of artwork that uses the historic symbol as its central theme. VOA’s Julie Taboh was at the DC Chamber of Commerce for the show’s opening.

VOA Blogs