Summary |
This volume discusses strategies and public policies that countries and donors can use to mitigate the shortcomings of community-financing schemes designed along the lines of microinsurance. Reinsurance is emphasized as a mechanism for enlarging the risk pool and spreading risks across larger population groups, which no single microinsurance scheme could do on its own.
The volume also discusses other measures to strengthen microinsurance-based community-financing schemes, including improving the actuarial basis for determining the insurance premium needed to protect against expenditure fluctuations; introducing subsidies to pay for the premiums of law-income populations; using effective prevention and case-management techniques to limit expenditure fluctuations, notably through enhancements of benefits with high externalities; enlisting technical support to strengthen local schemes’ management capacity; and establishing and strengthening links with formal financing and provider networks.
The volume does not address some of the specific problems associated with other forms of community-financing schemes such as community involvement in user-fee management, facility-based mutual health organizations, revolving drugs funds, or subregional or district-level social health insurance programs. Nor does the volume address the intersectoral determinants of health outcomes, although policies that influence activities in these areas may have a profound impact on health and demand for health services. These include policies on education, water, sanitation, transport, national security, agriculture and food, and the multiple social and economic dimensions of development policy.
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