The Joint Learning Network 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.
Use the reforms browser below to filter programs by design feature, and click on a program for the full case study. Use the compare reforms feature to view comparable information across multiple programs at once.
| Name | Year Launched | |
|---|---|---|
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India: Rajiv Aarogyasri The Aarogyasri scheme was developed to improve social protection for the poor and reduce the financial and emotional consequences of indebtedness due to illness. Aarogyasri is state-financed and targets individuals living below the poverty line in Andhra Pradesh. Beneficiaries have access to numerous modern medical facilities and are navigated through the health care system by Aarogya Mithras, or patient advocates, hired to oversee each in-network hospital. ... |
2007 |
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India: Rashtriya Swasthya Bima Yojna (RSBY) RSBY was launched to provide health coverage to all those living below the poverty line in India. Under the scheme, beneficiaries are entitled to hospitalization coverage of up to Rs. 30,000/- annually (approximately USD 700) for most diseases. Beneficiaries pay Rs. 30/- as a registration fee, while the central and state governments pay the premium to the insurer. The objectives of RSBY are to:
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2008 |
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Ghana: National Health Insurance Scheme (NHIS) In 2004, Ghana embarked on a process of developing and implementing a National Health Insurance Scheme (NHIS) to replace out-of-pocket fees at point of service. The solution was a ‘hub-satellite’ model of a national fund and authority (the hub) that regulates and subsidizes a national network of community-based health insurance schemes (CBHIs) (the satellites). As the vast majority of Ghanaians work in the informal economy, it was recognized early on that a state sponsored statutory... |
2004 |
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Indonesia: Jamkesmas Indonesia introduced the first phase of its plan to achieve universal health coverage through a mandatory public health insurance scheme, Askeskin, in 2004. In 2008, Askeskin evolved into Jaminan Kesehatan Masyarakat, or Jamkesmas, an MoH-run “insurance” program which now covers over 76.4 million poor Indonesians. Asuransi Kesehatan Masyarakat Miskin, or Askeskin, was targeted to the poor and increased access to care and financial protection for the poorest. It initially targeted the poorest... |
2004 |
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Vietnam: Compulsory and Voluntary Health Insurance Schemes The Health Care Fund for the Poor (HCFP) was created in 2003 to provide care for the poor, ethnic minorities, and the disadvantaged. Initially implemented as a separate social program, HCFP was rolled into the national compulsory health insurance (CHI) scheme in July of 2009 as a result of a new National Health Insurance Law. The current national health insurance system consists of two parts, compulsory health insurance (CHI) and voluntary health insurance (VHI). CHI formally... |
2003 |
 |
Philippines: PhilHealth The Philippine Health Corporation, or PhilHealth, was created in 1995 with the aim of placing a renewed emphasis on achieving universal coverage. In 2000 and 2005, additional reform efforts were outlined to make decentralization and health insurance reform work more effectively, including an expanded government subsidy for the enrollment of the poor, the creation of local health service delivery/planning units to reduce fragmentation, and a stronger DoH role in regulation. Since... |
2005 |
 |
Thailand: Universal Coverage Scheme With a great deal of popular support, the new Thai government passed the National Health Security Act in 2002. It has since become one of the most important social tools for health systems reform in Thailand. The new Universal Coverage Scheme (UCS), or “30 Baht Scheme”, combined the already existing Medical Welfare Scheme and the Voluntary Health Card Scheme to expand coverage to an additional 18 million people. Private health insurance organizations play no role in this reform, and... |
2001 |
 |
Chile: National Health Fund (FONASA) Chile’s health system is composed of mandatory health insurance that can be either public or private. Public insurance is offered through a single non-profit provider, the National Health Fund (FONASA). Private insurance can be purchased from many for-profit or not-for-profit private health insurance institutions known as ISAPREs. All formal sector workers who are not self-employed, self-employed workers with a retirement fund, and all retirees with a pension must enroll with either the... |
1979 |
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Brazil: Unified Health System (SUS) The 1988 constitution crystallized the movement toward democratization. One of the primary tenets of this new constitution was the de jure establishment of free, universal healthcare. Such a goal would be pursued through the Unified Health System (SUS), a newly established administrative body responsible for the stewardship of both the public and private health systems. The primary purpose of the SUS was to decentralize health policy down to the level of the state and municipality, with... |
1988 |
 |
Mali: Mutuelles The institutional reform in 2000 created the National Social Protection and Economic Solidarity Department, providing better supervisory capacity with the creation of a unit dedicated to strengthening stakeholder capacities for developing the Mutuelle system. These include the Association Support Center, Mutuelle and Cooperative Societies (CAMASC). In 2002, the government of Mali adopted a national social protection policy, followed in 2004 by a national action plan to extend social... |
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Mexico: Seguro Popular The Seguro Popular (SP) insurance program began as a pilot in 2001 and became law in 2003 with the passage of the System of Social Protection in Health (SPSS) legislation. The reform aimed to shift the portion of the health system that functioned as a national health service toward an insurance based system. The structural reform was designed to provide financial protection by offering publicly provided health insurance to the nearly 50 million Mexicans (50% of the population) who did not... |
2003 |