Back To Top

foto1 foto2 foto3 foto4 foto5
Submit Your article Call for Paper Submit Your article Call for Paper Submit Your article Call for Paper

Our Journals

Latest News & Update


Dr.Niraj K Pawan, Ms.Priyanka Kapoor, Dharmendra Ahuja*

Directorate of Medical & Health Services, Govt. of Rajasthan, Jaipur, Rajasthan, india.

 Email:  This email address is being protected from spambots. You need JavaScript enabled to view it.



The health inequities remain high in Indian subcontinent as health Expenses clearly favors the rich population & organized sector workers, the Out of reach (OOR) spending is as high as 79% which affects the poor in the very bad manner. The focus of the manuscript is to examine the potential which Group Health Insurance (GHI) offers to improve the health-care access of rural, low-income population & the people in unorganized sector. This is done by drawing empirical evidence from various nations on their experiences of implementing GHI Programs & its potential for applications to Indian subcontinent, problems & challenges faced & the policy & management lessons that may be applicable to Indian subcontinent. It can be concluded that GHI Programs have proved to be effective in reducing the Catastrophic Health Expense (CHE) of people. But success of such Programs depends on its design, benefit package it offers, its management, economic & non-economic benefits perceived by enrollees & solidarity among community members. Collaboration of government, NGO’s & donor agencies is very crucial in extending coverage; similarly overcoming the mistrust that people have from such Programs & subsidizing the insurance for the many who cannot pay the premiums are paramount factors for success of GHI in Indian subcontinent. One of the biggest challenges for the health system is to address the piecemeal approach of GHI Programs in extending health insurance & inability of such Programs to cover a large number of poor & the unorganized sector workers. Also, there is a need for a stronger policy research to demonstrate: 1) how such Programs can cover a larger risk pool, 2) how such Programs can enroll a large number of people in the unorganized sector, 3) the interaction of GHI Programs with other funding Programs & its link to the health system.

Keyword: Community Based Health Insurance, Catastrophic Health Expense, Healthcare Funding, Health Equity, Indian subcontinent


  1. Gottret, P. & Scheiber, G. 2006  Health Funding Revisited: A Practitioner’s Guide. The World Bank, Washington DC.
  2. WHO 2000 Who Pays for the Health System? The World Health Report 2000, WHO, Geneva.
  3. Hsiao, W. 2007 Why Is a Systematic View of Health Funding Necessary? Health Affairs, 26, 950-961.
  4. NRHM Mission Document 2005-2012.
  5. Selvaraj, S. 2011 A Critical Assessment of Existing Health Insurance Models in Indian subcontinent. Planning Commission of Indian subcontinent, New Delhi.
  6. Ahuja, R. 2004 Health Insurance for Poor. Economic & Political Weekly, 34, 3171-3178.
  7. Shiva, A.K., Chen, L.C., Mita, C., et al. 2011 Funding Health Care for All: Challenges & Opportunities. The Lancet, 377, 668-679.
  8. Garg, C. 1998 Equity of Health Sector Funding & Delivery in Indian subcontinent: Harvard School of Public Health.
  9. Peters, D., Yazbeck, A., Sharma, R., Ramana, G., Pritchett, L. & Wagstaff, A. 2002 Better Health Systems for In-dia’s Poor: Findings, Analysis & Options. The World Bank, Washington DC.
  10. Informal Sector in Indian subcontinent: Approaches for Social Security. unorganised-labour/informal_sector_in_indian subcontinent_-_approaches_for_social_se  curity.pdf/view
  11. Ministry of Statistics & Programme Implemen-tation.
  12. Van Damme, W., Van Leemput, L., Por, I., Hardemann, W. & Meessen, B. 2004 Out-Of-Pocket Health Expendi-ture & Debt in Poor Households: Evidence from Cambodia. Tropical Medicine & International Health, 9, 273-280. 1046/j.1365-3156.2003.01194.x
  13. Devadasan, N., Criel, B., Damme, W.V., Ranson, K. & Stuyft, P.V. 2007 Indian subcontinentn Community Health Insurance Programs Provide Partial Protection against Catastrophic Health Expense. BMC Health Services Research, 7, 43.
  14. Mahal, A., Karan, A. & Engelau, M. 2010 The Economic Implications of Non-Communicable Disease for Indian subcontinent. World Bank, Washington DC.
  15. Dong, H., Kouyate, B., Cairns, J. & Sauerborn, R. 2005 Inequality in Willingness-To-Pay for Community-Based Health Insurance. Health Policy, 72, 149-156. 02.014
  16. Preker, A., Carrin, G., et al. 2001 Role of Communities in Resource Mobilization & Risk Sharing: A Synthesis Re-port. World Health Organization, Geneva, 41.
  17. Benett, S. 2004 The Role of Community-Based Health Insurance within the Health Care Funding System: A Framework for Analysis. Health Policy & Planning, 19, 147-158. heapol /czh018
  18. Sauerborn, R., Nougtara, A., Hien, M. & Diesfeld, H.J. 1996 Seasonal Variations of Household Costs of Illness in Burkina Faso. Social Science & Medicine, 43, 281-290. (95) 00374-6
  19. Ranson, M.K. 2002 Reduction of Catastrophic Health Care Expenses by a Community-Based Health Insurance Program in Gujarat, Indian subcontinent: Current Experiences & Challenges. Bulletin of the World Health Organization, 80, 613-621.
  20. Liu, Y. & Hsiao, W.C. 2003 For the People, by the People: Community Funding of Healthcare in Developing Nations. Harvard Health Policy Review, 4, 102-111.
  21. Allegri, M., Sanon, M. & Sauerborn, R. 2006 To Enroll or Not to Enroll? A Qualitative Investigation of Dem& for Health Insurance in Rural West Africa. Social Science & Medicine, 62, 1520-1527.
  22. Zeller, M. & Sharma, M. 1998 Rural Finance & Poverty Alleviation: Food Policy Report. International Food Pol-icy Research Institute, Washington DC.
  23. Bennett, S., Creese, A. & Monasch, R. 1998 Health Insurance Programs for People outside Formal Sector Employ-ment. World Health Organization, Geneva.
  24. Bhat, R. & Jain, N. 2006 Factors Affecting the Dem& for Health Insurance in a Micro Insurance Program. Work-ing Manuscript No. 2006-07-02, Indian subcontinent Institute of Management, Ahmadabad.
  25. Acharaya, A. & Ranson, M.K. 2005 Healthcare Funding for the Poor: Group Health Insurance Programs in Gujarat. Economic & Political Weekly, 40, 4141-4150.
  26. Sinha, T., Ranson, K., Chatterjee, M., Acharya, A. & Mills, A. (2006) Barriers to Accessing Benefits in a Communi-ty-Based Health Insurance Program: Lessons Learnt from SEWA Insurance, Gujarat. Health Policy & Planning, 21, 132-142.
  27. Mathiyazhagan, K. 1998 Willingness to Pay for Rural Health Insurance through Community Participation in Indian subcontinent.  The International Journal of Health Planning & Management, 13, 47-67. 1 <47::AID-HPM495>3.0.CO;2-I
  28. Desai, S. 2009 Keeping the “Health” in Health Insurance. Economic & Political Weekly, XLIV, 18-21.
  29. Ranson, M.K., Sinha, T., Chatterjee, M., G&hi, F., Jayswal, R., Patel, F., Morris, S.S. & Mills, A.J. 2007 Equita-ble Utilization of Indian subcontinentn Group Health Insurance Program among Its Rural Membership: Cluster R&o-mized Controlled Trial. British Medical Journal, 334, 1282-12783.
  30. Bärnighausen, T., Liu, Y., Zhang, X. & Sauerborn, R. 2007 Willingness to Pay for Social Health Insurance among Informal Sector Workers in Wuhan, China: A Contingent Valuation Study. BMC Health Services Research, 7, 114.


Copyright © 2018 International Organization of Scientific Invention Rights Reserved.