Community based health insurance in developing countries

BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39240.632963.80 (Published 21 June 2007) Cite this as: BMJ 2007;334:1282
  1. Manuela De Allegri, research associate,
  2. Rainer Sauerborn, professor and head of department
  1. Department of Tropical Hygiene and Public Health, University of Heidelberg, 69120 Heidelberg, Germany
  1. manuela.de.allegri{at}urz.uni-heidelberg.de

    Removing financial barriers is only the first step towards better access to care for poor people

    In this week's BMJ, a cluster randomised controlled trial by Ranson and colleagues describes a community based health insurance scheme run by the Self Employed Women's Association (SEWA) in Gujarat, India.1 Community based health insurance is a valuable way to finance the delivery of health services in developing countries. By combining the risk of falling sick with resources, such insurance facilitates access to care and offers financial protection against the cost of illness. In doing so, community based health insurance aims to overcome inequities in access and socioeconomic status by reducing existing gaps between the poor and the less poor.

    Research from Asia and sub-Saharan Africa shows that community based health insurance has been less effective in securing equity than expected. Poor people are less likely to enrol in …

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