Blogs tagged: Informal Sector

Universal Health Coverage and the Informal Sector in Low Income Countries

This article was distributed on July 8, 2011 in the HHA Financing Communities of Practice Newsletter

The question of how to achieve universal health coverage (UHC) in low-income countries can be distilled to how to ensure coverage for the informal sector.[1]

In Sub-Saharan African (SSA) in particular, many countries inherited European-style social security systems at independence, which provided relatively generous social protection to the very limited population working in the formal sector. In the mostly cash crop based economies of Africa at the time, this so-called welfare state was largely financed by the peasants and farmers of the informal sector who did not benefit from such coverage. In fact, it was not uncommon to hear arguments back then that the informal sector could not be covered by health insurance schemes because it was inherently difficult to estimate their revenues and to collect their premiums.

Universal Coverage Ensuring Value-for Money Healthcare is Key

Affordability and sustainability of universal health coverage

Francoise Cluzeau is a Senior Advisor for NICE International. She attended the June 2011 JLN Mombasa Workshop as an international observer.

At the JLN workshop in Mombasa we heard about many creative schemes targeting improved coverage of the informal sector - such as the establishment of the Mutuelles in Rwanda, the Rajiv Aarogyasri Community Health Insurance Scheme in India, the national citizen ID number for universal coverage in Thailand and many more exciting initiatives from other countries. At the same time we heard common issues evoked about the affordability and sustainability of universal healthcare coverage.

Informal Sector Enrollment as a Tool for Improving Quality

Enrollment as a “pay for performance” technique

Helen L. Smits, MD, attended the JLN Mombasa workshop as a representative of the Institute for Healthcare Improvement (IHI). She is an internist who has dedicated her life to public health and healthcare management. Her current work focuses on improving the quality of care in African countries.

During the presentations and discussions in Mombasa, we learned a lot about the potential for community-based organizations to contribute to the process for enrolling the informal sector into insurance schemes. Examples included the women’s groups described in Frances’ Lund’s post, the community organizations used by RSBY in India, and the microfinance organizations used by KaSAPI in the Philippines.

Raising Revenue to Cover the Informal Sector

Different strategies for raising revenue to cover the informal sector

Panelists representing Ghana, Mali, Indonesia, Rwanda and the World Bank discussed the challenges of raising revenues for covering the informal sector at the JLN workshop session in Mombasa on June 7, 2011. Debated were the relative merits of different strategies for raising revenues such as general taxes, payroll taxes, special earmarked taxes, donor and community contributions.

During the June 7, 2011, JLN workshop session on raising revenue to cover the informal sector it emerged that most countries, in fact, utilize a mix of financing sources, although one source may be more dominant than the others. The financing source may also differ according to the population group(s) being targeted – thus payroll taxes tend to predominate when it concerns the formal sector, while a mix of sources is more relevant to cover the informal sector due to the many complexities of raising sufficient premium income from that sector and the large numbers who may not be able to pay premiums for themselves.

Engaging Informal Workers During Insurance Program Design

Advocating for women working in the informal economy to participate in the design of programs benefitting them

This blog was written by Frances Lund, Director, Social Protection at WIEGO and Senior Research Associate for the School of Development Studies at the University of KwaZulu-Natal. Ms. Lund will conduct a session titled "Women in Informal Employment: Globalizing and Organizing (WIEGO) Initiative" during the Expanding Coverage JLN Workshop in Mombasa, Kenya from June 6-10, 2011

On Wednesday, June 8th, 2011, I will conduct a session on Women in Informal Employment: Globalizing and Organizing (WIEGO) and our work with member-based organizations of poorer working people, especially women informal workers. WIEGO works to enable the voice of informal women workers – who are ‘the experts’ in terms of their own health needs and priorities – to be heard in different platforms.