CONTEXT AND RATIONALE

KNOWLEDGE

EVENTS

Despite recent increases in developmental assistance for providing social protection, the poor in many developing countries continue to suffer from the absence of meaningful social security coverage. For example, in the context of healthcare, out-of-pocket transactions continue to make up more than half of healthcare-related expenditures in at least 19 countries in Asia and 15 countries in Africa. Additional analyses indicate that, each year, 44 million people face severe financial hardship around the world, and a further 25 million are forced into poverty due to payments for health services.

Over the past decade, in many countries, a number of national or state-level reforms have been implemented by governments that are committed to providing universal social security coverage. Many organisations and initiatives, such as Deutsche Gesellschaft fuer Internationale Zusammenarbeit (GIZ); the Health Insurance Fund; International Labour Organisation (ILO); Department for International Development (DFID); United Nations Development Program (UNDP); USAID Health System 20/20; the World Bank; The Providing for Health Initiative (P4H); Joint Learning Platform, etc.; provide helpful policy assistance on this topic and generate valuable information on these new and innovative reforms.

Universal social security coverage, including healthcare, pensions, life and accident insurance, is an ambitious goal and challenging to implement successfully. Attempts to introduce reforms can face policy challenges such as financing, designing subsidies to target qualifying populations and expanding coverage to include new populations. They can also face implementation challenges involving the use of new technologies to support operations, monitoring and evaluation.
These challenges can be exacerbated by political and economic circumstances as well as in-country capacity constraints. Meanwhile, many countries can learn lessons from the past decade of reforms and best practices can serve as a reference point for countries which are about to initiate reforms on social security.