Compare: Population covered

Joint Learning Network for Universal Health Coverage

The Joint Learning Network for Universal Health Coverage systematically documents the reforms of its member countries and other countries that have expanded health coverage through demand-side financing. The case studies contained in these pages are brief, comparative and modular in nature, describing the key highlights and technical features of each program.


Compare various dimensions of country reform efforts using our interactive tool.


Program Target population Coverage Population covered
Kyrgyz Republic: Mandatory Health Insurance Fund (MHIF)
  • All populations
 5.2 million

Kyrgyzstan offers free primary health care services to all citizens through the State Guaranteed Benefits Package (SGPB) regardless of insurance status. By 2003, 98% of the population was enrolled with a Family Group Practice (FGP) for their primary health care needs.

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Kyrgyzstan offers free primary health care services to all citizens through the State Guaranteed Benefits Package (SGPB) regardless of insurance status. By 2003, 98% of the population was enrolled with a Family Group Practice (FGP) for their primary health care needs. Enrollees choose a FGP of their choice and are free to move between FGPs once per year during the annual registration period.

Population groups covered by the MHIF include formal sector employees, civil servants, pensioners, the registered unemployed, children and students under age 21, welfare benefit recipients, farmers, and the self-employed. In 2001, over 80% of the population was covered by the MHIF.

Table 3: Coverage additions (1997-2001): Population groups, sources of financing and benefits

Population groupYearSource of financingServices provided (depth of coverage)
Formal sector employees, except civil servants19972% from the wage bill administered by the Social Fund (SF)Drugs at hospital level, salary bonuses
1998Emergency care at the primary level
2000Additional/outpatient drug package
Civil servants19982% from the wage bill administered by the SFDrugs at hospital level, salary bonuses
2000Additional/outpatient drug package
Pensioners1997Value of 1.5x minimum salary administered by the SF (Pension Fund)Drugs at hospital level, salary bonuses
1998Emergency care at primary level
2000Additional/outpatient drug package
2003Republican budgetCoverage unchanged
Registered unemployed1997Value of 1.5x minimum salary administered by SF (Unemployment Fund)Drugs at hospital level, salary bonuses
1998Republican budgetEmergency care at primary level
2000Additional/outpatient drug package
2002Effectively not covered: no funding provided this group by Republican budget
Children and students under 212000Value of 1.5x minimum salaryDrugs at hospital level, salary bonuses
Republican budgetEmergency care at the primary level
Additional/outpatient drug package
Welfare benefits recipients2000Value of 1.5 minimum salaryDrugs at hospital level, salary bonuses
Republican budgetEmergency care at the primary level
Additional/outpatient drug package
Farmers19972% of the land tax administered by SF (5% in 2000, 6% in 2003)Drugs at hospital level, salary bonuses
Emergency care at primary level
2002Health insurance policies (400 KGS = US $10/year) administered by MHIFCoverage unchanged
Self-employed19982% of the value of 3x minimum salaryDrugs at hospital level, salary bonuses
Emergency care at primary level
2000Additional/outpatient drug package
2002Health insurance policies (400 KGS = US$10/year) administered by the MHIFCoverage unchanged

Source: Jakab, M., and Manjieva, E.

Mandatory Health Insurance Fund (MHIF)

Population covered

Target Populations: All populations
Coverage Level: 5.2 million

Kyrgyzstan offers free primary health care services to all citizens through the State Guaranteed Benefits Package (SGPB) regardless of insurance status. By 2003, 98% of the population was enrolled with a Family Group Practice (FGP) for their primary health care needs. Enrollees choose a FGP of their choice and are free to move between FGPs once per year during the annual registration period.

Population groups covered by the MHIF include formal sector employees, civil servants, pensioners, the registered unemployed, children and students under age 21, welfare benefit recipients, farmers, and the self-employed. In 2001, over 80% of the population was covered by the MHIF.

Table 3: Coverage additions (1997-2001): Population groups, sources of financing and benefits

Population groupYearSource of financingServices provided (depth of coverage)
Formal sector employees, except civil servants19972% from the wage bill administered by the Social Fund (SF)Drugs at hospital level, salary bonuses
1998Emergency care at the primary level
2000Additional/outpatient drug package
Civil servants19982% from the wage bill administered by the SFDrugs at hospital level, salary bonuses
2000Additional/outpatient drug package
Pensioners1997Value of 1.5x minimum salary administered by the SF (Pension Fund)Drugs at hospital level, salary bonuses
1998Emergency care at primary level
2000Additional/outpatient drug package
2003Republican budgetCoverage unchanged
Registered unemployed1997Value of 1.5x minimum salary administered by SF (Unemployment Fund)Drugs at hospital level, salary bonuses
1998Republican budgetEmergency care at primary level
2000Additional/outpatient drug package
2002Effectively not covered: no funding provided this group by Republican budget
Children and students under 212000Value of 1.5x minimum salaryDrugs at hospital level, salary bonuses
Republican budgetEmergency care at the primary level
Additional/outpatient drug package
Welfare benefits recipients2000Value of 1.5 minimum salaryDrugs at hospital level, salary bonuses
Republican budgetEmergency care at the primary level
Additional/outpatient drug package
Farmers19972% of the land tax administered by SF (5% in 2000, 6% in 2003)Drugs at hospital level, salary bonuses
Emergency care at primary level
2002Health insurance policies (400 KGS = US $10/year) administered by MHIFCoverage unchanged
Self-employed19982% of the value of 3x minimum salaryDrugs at hospital level, salary bonuses
Emergency care at primary level
2000Additional/outpatient drug package
2002Health insurance policies (400 KGS = US$10/year) administered by the MHIFCoverage unchanged

Source: Jakab, M., and Manjieva, E.
Kenya: National Hospital Insurance Fund
  • All populations
 2.7 million

To be a member of the National Hospital Insurance Fund (NHIF), one must simply be a Kenyan resident age 18 or older. NHIF covers certain dependents of the primary policy holder automatically, including spouses, children under the age of 18, students (even if over the age of 18), and disabled dependents. Other adult family members require separate premium contributions to be covered. NHIF is responsible for enrolling and registering all eligible members from the formal and informal sectors.

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To be a member of the National Hospital Insurance Fund (NHIF), one must simply be a Kenyan resident age 18 or older. NHIF covers certain dependents of the primary policy holder automatically, including spouses, children under the age of 18, students (even if over the age of 18), and disabled dependents. Other adult family members require separate premium contributions to be covered. NHIF is responsible for enrolling and registering all eligible members from the formal and informal sectors.

Total membership in NHIF rose from about 206,000 in 1998 to 1,372,000 in 2006. By 2011 about 2.7 million people were insured by NHIF, 2.1 million of which are employed in the formal sector. Approximately 88% of the people with insurance in Kenya are insured by the NHIF. However, currently only about 25% of the poor have medical coverage. Recently, NHIF has embarked on a program to work with community-based organizations to expand informal sector membership.

National Hospital Insurance Fund

Population covered

Target Populations: All populations
Coverage Level: 2.7 million

To be a member of the National Hospital Insurance Fund (NHIF), one must simply be a Kenyan resident age 18 or older. NHIF covers certain dependents of the primary policy holder automatically, including spouses, children under the age of 18, students (even if over the age of 18), and disabled dependents. Other adult family members require separate premium contributions to be covered. NHIF is responsible for enrolling and registering all eligible members from the formal and informal sectors.

Total membership in NHIF rose from about 206,000 in 1998 to 1,372,000 in 2006. By 2011 about 2.7 million people were insured by NHIF, 2.1 million of which are employed in the formal sector. Approximately 88% of the people with insurance in Kenya are insured by the NHIF. However, currently only about 25% of the poor have medical coverage. Recently, NHIF has embarked on a program to work with community-based organizations to expand informal sector membership.
India: Rajiv Aarogyasri
  • Below Poverty Line
 65 million people

Aarogyasri covers all below-the-poverty-line residents of Andrah Pradesh. The scheme has been implemented in all districts in the state. Upon enrollment, beneficiary households receive a Rajiv Aarogyasri Bhima Health Card, a mechanism through which patients are identified and medical records are kept.

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Aarogyasri covers all below-the-poverty-line residents of Andrah Pradesh. The scheme has been implemented in all districts in the state. Upon enrollment, beneficiary households receive a Rajiv Aarogyasri Bhima Health Card, a mechanism through which patients are identified and medical records are kept. Aarogyasri covers all below-the-poverty-line residents of Andrah Pradesh. The state already had a mechanism for defining, identifying, and enrolling below-the-poverty-line families. Each eligible family is issued a “White Card” (a ration card) to identify them as below-the-poverty line. Aarogyasri uses the “White Card” as a targeting mechanism for its scheme.

Families in the state who already have “White Cards” are provided with Rajiv Aarogyasri Bhima Health Cards. Everyone in a household can be included in the Rajiv Aarogyasri Health Card. This means the head of the family, spouse, dependent children, and dependent parents. The Health Card captures the family’s data and pictures of each family member. It is presented by beneficiaries when they arrive at a health facility to identify them. The card is also used to store patient visit records and transmit utilization information.

Once enrolled, beneficiaries are guided through the process of seeking care. In order to ensure that beneficiaries know what benefits they are entitled to, and are able to navigate the system of care, Aarogyasri has developed a team of 4,000 Aarogya Mithras. Aarogya Mithras are health workers representing the community of the insured. One Aarogya Mithra sits in each primary health center across the state. These health centers are most often the first points of contact for most families seeking care. In addition, district hospitals and network hospitals also have help desks manned by Aarogya Mithras to facilitate smooth service delivery for Aarogyasri beneficiaries. Aarogya Mithras help to guide beneficiaries through the network of care and inform them about their insurance benefits.

In addition to contacts with Aarogya Mithras, beneficiaries can visit health screening camps that are set up by network providers in rural areas. Under the scheme, all network hospitals are required to undertake a specified number of village health camps in order to maintain their network status. Beneficiaries and potential beneficiaries attend the health camps to be screened for diseases and are provided with preventive care. Those that can be treated at the camp are treated; those that require further treatment are referred to network hospitals where their ailment will be treated free of cost under their Aarogyasri benefits. As of November 2009, there have been more than 15,000 camps and nearly 2.5 million people have been screened.

Rajiv Aarogyasri

Population covered

Target Populations: Below Poverty Line
Coverage Level: 65 million people

Aarogyasri covers all below-the-poverty-line residents of Andrah Pradesh. The scheme has been implemented in all districts in the state. Upon enrollment, beneficiary households receive a Rajiv Aarogyasri Bhima Health Card, a mechanism through which patients are identified and medical records are kept. Aarogyasri covers all below-the-poverty-line residents of Andrah Pradesh. The state already had a mechanism for defining, identifying, and enrolling below-the-poverty-line families. Each eligible family is issued a “White Card” (a ration card) to identify them as below-the-poverty line. Aarogyasri uses the “White Card” as a targeting mechanism for its scheme.

Families in the state who already have “White Cards” are provided with Rajiv Aarogyasri Bhima Health Cards. Everyone in a household can be included in the Rajiv Aarogyasri Health Card. This means the head of the family, spouse, dependent children, and dependent parents. The Health Card captures the family’s data and pictures of each family member. It is presented by beneficiaries when they arrive at a health facility to identify them. The card is also used to store patient visit records and transmit utilization information.

Once enrolled, beneficiaries are guided through the process of seeking care. In order to ensure that beneficiaries know what benefits they are entitled to, and are able to navigate the system of care, Aarogyasri has developed a team of 4,000 Aarogya Mithras. Aarogya Mithras are health workers representing the community of the insured. One Aarogya Mithra sits in each primary health center across the state. These health centers are most often the first points of contact for most families seeking care. In addition, district hospitals and network hospitals also have help desks manned by Aarogya Mithras to facilitate smooth service delivery for Aarogyasri beneficiaries. Aarogya Mithras help to guide beneficiaries through the network of care and inform them about their insurance benefits.

In addition to contacts with Aarogya Mithras, beneficiaries can visit health screening camps that are set up by network providers in rural areas. Under the scheme, all network hospitals are required to undertake a specified number of village health camps in order to maintain their network status. Beneficiaries and potential beneficiaries attend the health camps to be screened for diseases and are provided with preventive care. Those that can be treated at the camp are treated; those that require further treatment are referred to network hospitals where their ailment will be treated free of cost under their Aarogyasri benefits. As of November 2009, there have been more than 15,000 camps and nearly 2.5 million people have been screened.