ReviewBMJ global health2022
Universal health insurance in Africa: a narrative review of the literature on institutional models.
Review in BMJ global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 3 of them syntheses that pooled it.
What it found
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Who cites it
39 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Beneficiaries' satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Willingness to pay for National Health Insurance Services and Associated Factors in Africa and Asia: a systematic review and meta-analysis.Frontiers in public health · 2024Pooled it
- The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis.Global health action · 2023Pooled it
- Financial protection failure among urban poor populations in Karachi, Pakistan: a cross-sectional household survey of catastrophic health expenditure prevalence, determinants and insurance effectiveness.BMJ public health · 2026Article
- Health financing strategies for achieving Universal Health Coverage in low- and middle-income countries: a narrative review.Frontiers in public health · 2026Review
- Article
- Institutional design features of health insurance subsidy programmes in Africa: a narrative review.International journal for equity in health · 2025Review
- Implications of U.S. withdrawal from the World Health Organization on health financing in Africa.Health policy OPEN · 2025Article
- Do free healthcare policies play a role in expanding national health insurance enrollment among informal sector workers? The case of the Afya Care pilot program in Kenya.BMC public health · 2025Article
- An evaluation of the impacts of health insurance coverage on wealth stratification in some selected sub-Saharan countries.Health economics review · 2025Article
- Youth Should Be Part of African Pharma Industry-A Perspective.Health science reports · 2025Article
- Socioeconomic impacts of community-based health insurance: evidence from Gondar Zuria District, Amhara Regional State, Ethiopia.Health research policy and systems · 2025Article
- Cost-effectiveness of health insurance among women engaged in transactional sex and impacts on HIV transmission in Cameroon: a mathematical model.BMJ global health · 2025Article
- HIV response financing challenges in Sub-Saharan Africa: barriers to achieving the 95-95-95 UNAIDS targets.Frontiers in public health · 2025Review
- Trapped by debt: an ethnographic study of medical indebtedness and hospital detention in the Fundong Health District, Cameroon.Frontiers in public health · 2025Article
- Moving toward universal health coverage with a national health insurance program: A scoping review and narrative synthesis of experiences in eleven low- and lower-middle income countries.PLOS global public health · 2025Article
- What factors shape an individual's probability to be enrolled in a professionally-managed community-based health insurance? Results from a cross-sectional case-control study in two districts in Mali.PLOS global public health · 2025Article
- Sustainable financing for vaccination towards advancing universal health coverage in the WHO African region: The strategic role of national health insurance.Human vaccines & immunotherapeutics · 2024Article
- Emergency Obstetric Care Access Dynamics in Kampala City, Uganda: Analysis of Women's Self-Reported Care-Seeking Pathways.Global health, science and practice · 2024Article
- Patient's willingness to pay for improved community health insurance in Tanzania.Health policy OPEN · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionSeveral African countries have introduced universal health insurance (UHI) programmes. These programmes aim to extend health insurance to groups that are usually excluded, namely informal workers and the indigent. Countries use different approaches. The purpose of this article is to study their institutional characteristics and their contribution to the achievement of universal health coverage (UHC) goals.
methodThis study is a narrative review. It focused on African countries with a UHI programme for at least 4 years. We identified 16 countries. We then compared how these UHI schemes mobilise, pool and use funds to purchase healthcare. Finally, we synthesised how all these aspects contribute to achieving the main objectives of UHC (access to care and financial protection).
resultsNinety-two studies were selected. They found that government-run health insurance was the dominant model in Africa and that it produced better results than community-based health insurance (CBHI). They also showed that private health insurance was marginal. In a context with a large informal sector and a substantial number of people with low contributory capacity, the review also confirmed the limitations of contribution-based financing and the need to strengthen tax-based financing. It also showed that high fragmentation and voluntary enrolment, which are considered irreconcilable with universal insurance, characterise most UHI systems in Africa.
conclusionPublic health insurance is more likely to contribute to the achievement of UHC goals than CBHI, as it ensures better management and promotes the pooling of resources on a larger scale.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.