Working Paper 156

Universal Health Insurance Schemes: A comparative analysis of implementation features in 10 low- and middle-income countries

Achieving universal health coverage is a key objective of social protection systems. Countries use different mechanisms to guarantee social health protection, and this report focuses on those adopting universal health insurance models. While existing literature addresses scheme design, evidence on implementation in low- and middle-income countries remains limited—particularly regarding how vulnerable groups, such as the poor and informal workers, are effectively included. Drawing on case studies from ten countries, the report shows that national historical and socio-economic contexts have led to diverse approaches to designing and delivering universal health insurance.

Universal health insurance (UHI) schemes are a key policy approach for advancing universal health coverage in low- and middle-income countries. This publication presents a comparative overview of UHI schemes in ten countries, highlighting common design features and implementation approaches.

By examining similarities and differences across country experiences, the analysis aims to identify broad patterns, challenges, and considerations relevant to the development and expansion of UHI schemes. The findings are intended to inform policymakers and practitioners engaged in the design and implementation of health insurance reforms in diverse contexts.

Additional details

Author(s)

  • Martina Bergthaller
  • Lou Tessier

References