Skip to main content

Table 1 Summary of reforms of focus and methodological approach in country case studies

From: Promoting universal financial protection: evidence from seven low- and middle-income countries on factors facilitating or hindering progress

Country

Reforms of focus

Methodological approach

Costa Rica

• Phased extension since 1940 of mandatory insurance coverage, through the social security fund (Caja Costarricense de Seguro Social: CCSS), to the entire population, beginning with formal-sector employees in urban areas, then to rural employees, and then to the self-employed and the poor (with government paying the contribution for the poor from tax funds)

• Qualitative study using document reviews, key-informant interviews and focus group discussions (FGDs)

• Historical lens applied

• Used actor mapping framework

• Used policy analysis triangle framework

• Bringing hospitals under the control of the mandatory insurance scheme and improving primary health care services

 

Georgia

• Providing insurance coverage for the poor, using government funds to pay private health insurance scheme contributions (Medical Insurance for the Poor (MIP) program)

• Mixed methods: analysis of secondary national household survey data and primary qualitative data collection and analysis (key-informant interviews and FGDs)

India

• Providing insurance coverage for the poor, using government funds to pay contributions to health insurance schemes (public or private) (Rashtriya Swasthya Bima Yojana: RSBY initiative)

• Mixed methods: household survey of beneficiary households; and key-informant interviews and FGDs

Malawi

• Contracting (establishing Service Level Agreements - SLAs) with faith-based providers to provide health services free of charge to vulnerable populations, particularly for maternal and neonatal services

• Case study design (facility-based SLA as the unit of analysis)

• Mixed methods: exit survey and key-informant interviews

Nigeria

• Efforts to extend coverage of the National Health Insurance Scheme from the initial target membership of Federal civil servants to State civil servants

• Case study design (state as the unit of analysis)

• Qualitative study using document review and key-informant interviews

Tanzania

• Transfer of management of district level community-based voluntary health insurance schemes (Community Health Fund: CHF) to the National Health Insurance Fund (NHIF), a mandatory scheme initially established for civil servants but now open to other formal-sector workers

• Case study design (district as the unit of analysis)

• Mixed methods: key-informant interviews and focus group discussions; review of facility financial and utilisation records

Thailand

• Phased extension of mandatory insurance coverage to entire population

• Case study design (policy design feature as the unit of analysis)

• Qualitative study using key-informant interviews and document reviews

• Used policy analysis triangle framework

• Used policy network approach