A systematic review of community-based health insurance programs in South Asia

Background: Community-based health insurance (CBHI) has been evolving as an effective means of healthcare financing in many countries of South Asia. A systematic review in this context would give a comprehensive report of the performance of these schemes in terms of improving the health-seeking behaviour of the beneficiaries enrolled for the schemes. Methods: Important databases like PubMed, Elsevier, SocINDEX (EBSCO), Cochrane Reviews, Medline and Scopus were reviewed along with relevant portals—Google Scholar, www.who.int/, www.worldbank.org and www.cochrane.org—and specific journals and discussion series with published literature in the areas of community health insurance and health microfinance. Results: The review finally chronicles 20 CBHI schemes from published and unpublished literature from the countries comprising South Asia. These schemes have been reviewed in terms of their enrolment process, entry point and the extent to which they have contributed to the healthcare-seeking behaviour. Conclusion: The CBHI schemes can also serve as an alternative healthcare financing mechanism where fee-for-service and user fees have not made any impact. There have been very few studies that have tried to carry out an impact evaluation of the CBHI schemes on the target population, and more and more such studies can be a scope for further research.