Scoping review paper: Title Health insurance for scaling up Universal Health Coverage: A scoping review of selected countries and policy implications for Pakistan

Résumé fourni par la source

Health insurance programs are widely used to achieve Universal Health Coverage [1](#ref-0001) yet these are falling short of fulfilling the fundamental promise of UHC i.e. assurance of quality health care services, equitably and without the fear of financial hardship. This review identifies factors influencing the effectiveness of different health insurance programs and their scaling up process in achieving the UHC goals. The study also draws lessons for the national health insurance program and its effective scaling up in selected countries and including Pakistan. This scoping review concludes that the piecemeal and disjointed approach to 3.8.1 and 3.8.2 in UHC is a factor influencing negatively the progress towards UHC goals globally. This piece meal application of service coverage and financial protection only to cover secondary and tertiary care healthcare service packages affects the effectiveness of the health insurance programs in the range of countries examined. Moreover, the disjointed and inequitable application of the service coverage and financial protection across the income quintiles influence the scaling up of health insurance program to fill the cube of UHC. The review identifies suggestions for Pakistan. It highlights, with huge population size and increasing urbanization, a successful and accelerated scale up of health insurance in Pakistan may be achieved through a mixed pool of subsidized-contributory health insurance beneficiaries covering the entire continuum of care and pooling the range of household income (from poor to rich). Additionally, it also identifies that the urban population is a potentially low-hanging fruit for stepping up a sustainable scale up of the current health insurance program.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.