扩大赞比亚非正式部门的社会医疗保险覆盖范围:来自LMICs的经验教训和见解
Oliver Kaonga1,2, Jackson Otieno1, Mark Malema3
1African Institute for Development Policy (AFIDEP), Nairobi, Kenya.
Health systems and reform
|January 9, 2026
概括
低收入和中等收入国家 (LMICs) 的社会医疗保险 (SHI) 可以通过灵活的贡献和社区推广来扩大非正式工人的覆盖范围. 然而,实现全民健康覆盖 (UHC) 需要公共补贴和解决行政成本.
科学领域:
- 卫生政策和系统研究 卫生政策和系统研究
- 公共卫生 公共卫生
- 卫生经济学 卫生经济学
背景情况:
- 全民健康覆盖 (UHC) 是低收入和中等收入国家 (LMICs) 的一个关键目标.
- 社会医疗保险 (SHI) 是LMICs用于实现UHC的一种策略.
- 将SHI扩展到非正规部门的家庭对于增加覆盖率至关重要.
研究的目的:
- 审查在LMICs的SHI计划中招募和保留非正式部门家庭的战略和干预措施.
- 识别障碍和有效的方法,以使非正式部门纳入SHI.
主要方法:
- 对LMICs战略和干预措施的范围审查.
- 对SHI入学和留学的常见障碍和潜在解决方案的分析.
主要成果:
- 常见的障碍包括不规则的收入,低意识,行政障碍和信任问题.
- 有效的策略包括灵活的贡献,简化注册,宣传活动,社区结构和均衡的福利套餐.
- 创新的方法,如分层保费,移动支付和微型金融伙伴关系,可以解决障碍.
- 招生扩张往往需要公共补贴,并承担行政费用,净收入增长适度.
结论:
- 特定于环境的创新策略对于非正式部门纳入SHI至关重要.
- 通过SHI实现公平的获取需要承认财政限制和对公共资金的潜在需求.
- 学习的经验可以为国家计划提供信息,比如赞比亚的NHIS,以提高非正式部门的覆盖率.
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