Community Health Insurance in Developing Countries

The origins, formats, and evolution of CHI in Africa, Asia, and Latin America are described, with particular attention to factual issues such as management and support needs, scaling-up, the use of subsidies, and persistent knowledge gaps.

Abstract

Community Health Insurance (CHI) is a health insurance arrangement serving a social purpose, operating at the local level of the health system and thriving on community solidarity. This article describes the origins, formats, and evolution of CHI in Africa, Asia, and Latin America. It discusses the strengths, weaknesses, and opportunities of CHI from different perspectives: its contribution to equitable health-care access, to health sector financing, to provider responsiveness and quality of care, and to wider developmental objectives. Particular attention is drawn to factual issues such as management and support needs, scaling-up, the use of subsidies, and persistent knowledge gaps.