Community-based health insurance

Key Facts

• Community-based health insurance (CBHI) schemes are usually voluntary and characterized by community members pooling funds to offset the cost of healthcare.
• Despite much hope in these systems, evidence suggests the impact of CBHI on financial protection and access to needed health care are moderate for those enrolled.
• Most CBHI schemes have low participation levels and the poorest people usually remain excluded.
• Theory and practice show that CBHIs play only a limited role in helping countries move towards universal health care (UHC).
• They can have other positive impacts however, such as community development and local accountability of health care providers.

Overview

CBHI is a form of micro health insurance, which is an overarching term for health insurance targeted to low-income people. The specific feature of CBHIs is the community involvement in driving its setup and in its management.

Small, voluntary CBHI schemes are generally characterized by the following institutional design features.

• Pooling of health risks and of funds occurs within a community or a group of people who share common characteristics, such as geographical location or occupation.
• Membership premiums are often a flat rate and independent of individual health risks.
• Entitlements to benefits are linked to contributions in most cases.
• Affiliation is voluntary.
• The scheme operates on a non-profit basis

Information presented on this page has been replicated from the linked WHO fact sheet. Please always refer to the original source on who.int for the latest version. Last update: March 2024