The role of micro health insurance in providing financial risk protection in developing countries- a systematic review

BMC Public Health

Research Article

Shagufta Perveen¹  Shifa Salman Habib¹  Hussain Maqbool Ahmed Khuwaja² 

[1] Department of Community Health Sciences, The Aga Khan University, Stadium Road, 74800, Karachi, Pakistan;School of Nursing & Midwifery, The Aga Khan University, Stadium Road, 74800, Karachi, Pakistan;

关键词: Mutual health insurance;    Micro health insurance;    Community based health insurance;    Mutual health organizations;    Developing countries;    Financial protection;    Pakistan;    Systematic review;   

DOI  :  10.1186/s12889-016-2937-9

 received in 2015-10-09, accepted in 2016-03-08,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundOut of pocket payments are the predominant method of financing healthcare in many developing countries, which can result in impoverishment and financial catastrophe for those affected. In 2010, WHO estimated that approximately 100 million people are pushed below the poverty line each year by payments for healthcare. Micro health insurance (MHI) has been used in some countries as means of risk pooling and reducing out of pocket health expenditure. A systematic review was conducted to assess the extent to which MHI has contributed to providing financial risk protection to low-income households in developing countries, and suggest how the findings can be applied in the Pakistani setting.MethodsWe conducted a systematic search for published literature using the search terms “Community based health insurance AND developing countries”, “Micro health insurance AND developing countries”, “Mutual health insurance AND developing countries”, “mutual OR micro OR community based health insurance” “Health insurance AND impact AND poor” “Health insurance AND financial protection” and “mutual health organizations” on three databases, Pubmed, Google Scholar and Science Direct (Elsevier). Only those records that were published in the last ten years, in English language with their full texts available free of cost, were considered for inclusion in this review. Hand searching was carried out on the reference lists of the retrieved articles and webpages of international organizations like World Bank, World Health Organization and International Labour Organization.ResultsTwenty-three articles were eligible for inclusion in this systematic review (14 from Asia and 9 from Africa). Our analysis shows that MHI, in the majority of cases, has been found to contribute to the financial protection of its beneficiaries, by reducing out of pocket health expenditure, catastrophic health expenditure, total health expenditure, household borrowings and poverty. MHI also had a positive safeguarding effect on household savings, assets and consumption patterns.ConclusionOur review suggests that MHI, targeted at the low-income households and tailored to suit the cultural and geographical structures in the various areas of Pakistan, may contribute towards providing protection to the households from catastrophe and impoverishment resulting from health expenditures. This paper emphasizes the need for further research to fill the knowledge gap that exists about the impact of MHI, using robust study designs and impact indicators.

【 授权许可】

CC BY   
© Habib et al. 2016