Claims data from health insurance programmes in sub-Saharan Africa
An untapped resource to promote Universal Health Coverage
Bibliographic Data
| ID | 21879196 |
|---|---|
| Authors | Angela E Micah (0000-0002-0190-1017, Institute for Health Metrics and Evaluation, corresponding author), Maitreyi Sahu (0000-0002-1593-0193, Institute for Health Metrics and Evaluation) |
| Year | 2024 |
| Volume | 9 |
| Issue | 7 |
| Pages | e015310 |
| Publication date | 2024-07-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | BMJ Global Health (JOURNAL) |
| Journal identifiers | ISSN: 2059-7908 • E-ISSN: 2059-7908 |
| Publisher | BMJ (PUBLISHER • GB) |
| DOI | 10.1136/bmjgh-2024-015310 |
| PMID | 38991580 |
| OpenAlex | W4400570201 |
| Language | EN |
| References cited | 14 |
WHAT IS THE PROBLEM?In the effort to advance towards Universal Health Coverage (UHC), several African countries are implementing public health insurance programmes to increase financial risk protection, reduce catastrophic health expenditure and broaden access to services for treatment and prevention of disease. 1 2 In sub-Saharan Africa (SSA), 8 out of 49 countries have implemented some form of national-level contributory public health insurance system, and at least 7 others have passed legislation or are in the process of planning a national health insurance programme (Figure 1). 1 However, programmes face challenges with low enrolment, limited uptake of services and uncertain financial sustainability.These programmes can greatly benefit from analyses to identify opportunities for improvement and to support national policymaking.Health insurance claims data, which are primarily collected for administrative and financial purposes, capture a wealth of information on beneficiary demographics (eg, age, sex, geographic region), beneficiary utilisation patterns (including health services accessed) and total and out-of-pocket expenditure across beneficiaries, providers and health facilities.Globally, many countries use these data for both internal programme monitoring and in publishable reports and journal articles to support national-level programme design.Academic researchers may also use these data, when available, to study ways to make healthcare systems more efficient and equitable.Currently, among 15 countries in SSA with existing or planned national health insurance programmes, we identified only three-Ghana, Tanzania and Ethiopiawhich have used claims data in published research (Figure 1).Of these studies, only the
Business · Economic growth · Economics · Environmental health · Health care · Health insurance · Public health · Computer Science · Global Health Care Issues · Healthcare Policy and Management · Healthcare Systems and Reforms · Medicine · Nursing · Health Policy
| Citation velocity | historical |
|---|---|
| Highly cited | No |