IDEAS home Printed from
   My bibliography  Save this paper

Community-based health insurance and social protection policy


  • Tabor, Steven R.


Of all the risks facing poor households, health risks pose the greatest threat to their lives and livelihoods. A health shock adds health expenditures to the burden of the poor precisely at the time when they can afford it the least.One of the ways that poor communities manage health risks, in combination with publicly financed health care services, are community-based health insurance schemes (CBHIs). These are small scale, voluntary health insurance programs, organized and managed in a participatory manner. They are designed to be simple and affordable, and to draw on resources of social solidarity and cohesion to overcome problems of small risk pools, moral hazard, fraud, exclusion and cost-escalation. Less than 10 percent of the informal sector population in the developing nations has health coverage from a CBHI, but the number of such schemes is growing rapidly. On average, CBHIs recover between a quarter to a half of health service costs. As a social protection device, they have been shown to be effective in reducing out-of-pocket payments of their members, and in improving access to health services. Many schemes do fail. Problems, such as weak management, poor quality government health services, and the limited resources that local population can mobilize to finance health care, can impede success.

Suggested Citation

  • Tabor, Steven R., 2005. "Community-based health insurance and social protection policy," Social Protection and Labor Policy and Technical Notes 32545, The World Bank.
  • Handle: RePEc:wbk:hdnspu:32545

    Download full text from publisher

    File URL:
    Download Restriction: no

    References listed on IDEAS

    1. Jack, William, 2000. "Health insurance reform in four Latin American countries : theory and practice," Policy Research Working Paper Series 2492, The World Bank.
    Full references (including those not matched with items on IDEAS)


    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.

    Cited by:

    1. Bhattamishra, Ruchira & Barrett, Christopher B., 2010. "Community-Based Risk Management Arrangements: A Review," World Development, Elsevier, vol. 38(7), pages 923-932, July.
    2. Gnawali, Devendra Prasad & Pokhrel, Subhash & Sié, Ali & Sanon, Mamadou & De Allegri, Manuela & Souares, Aurélia & Dong, Hengjin & Sauerborn, Rainer, 2009. "The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso," Health Policy, Elsevier, vol. 90(2-3), pages 214-222, May.
    3. Greg Brunner & Pablo Gottret & Birgit Hansl & Vijayasekar Kalavakonda & Somil Nagpal & Nicole Tapay, 2012. "Private Voluntary Health Insurance : Consumer Protection and Prudential Regulation," World Bank Publications, The World Bank, number 13093.


    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wbk:hdnspu:32545. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Raiden C. Dillard). General contact details of provider: .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.