There is a renewed interest in how health financing systems in low-income countries can bridge the health financing gap and increase financial protection against the cost of illness. Evidence demonstrates that community financing can mobilise additional resources, increase access to care and provide some protection, although concerns remain about their ability to cover the poorest. There is an emerging international consensus that community prepayment schemes have a role to play in financing health care in resource poor environments, and increasing interest in scaling them up. Historical examples suggest voluntary insurance can play a significant role in the transition to universal coverage; there are also contemporary examples where it has contributed towards realising this policy objective in low-income settings. This paper reviews evidence from high- and low-income countries of the long-term contributions community financing has made to key health policy objectives including increasing population coverage, financial protection, equity, efficiency and quality of care. While identifying the contextual characteristics that facilitate this process, the paper discusses the role of community financing in developing universal and equitable financing systems.
HSD working paper, HSD/WP/13/06, 18 pp.