Many countries are committed to ensuring access to essential, quality health services for their citizens. Extending health insurance has been promoted as a means to remove financial barriers and improve access to health services for poorer citizens, as well as providing financial risk protection. In Africa, several countries have been particularly active in health insurance reforms. Most of the health insurance schemes in these countries, whether public or private, cover only a small proportion of the population, and efforts are now focused on scaling up coverage.
USAID’s Africa Bureau is documenting experiences and lessons from the region to inform country leaders and USAID missions. As part of this activity, HFG conducted case studies in Ghana, Ethiopia, and Senegal, on their experiences using community-based health insurance to expand health insurance coverage. Particular attention was given to contextual factors, including those relating to the political environment, to the perspective and influence of the various stakeholders, and to operational issues. Each of these three countries had (or has) active CBHI schemes that played (or are now playing) a role in a national reform to expand coverage.