Health Monitoring & Evaluation; Health Systems Development & Reform; Health Economics & Finance; Insurance & Risk Mitigation; Insurance Law
(Historic)Health, Nutrition & Population
Primary Health, Including Reproductive Health, Chi
Summary: This study of health insurance systems in Zaire was carried out as part of a larger program of initiatives designed to improve the sustainability of health care systems and increase the health status of the Zairian population. This paper presents the objectives of the study and a discussion of the economic aspects of health insurance, background information about the health sector and health financing systems in Zaire and highlights of previous related work. The major motivations for this study were: (a) to provide information for the ongoing social sector adjustment dialogue in Zaire; and (b) to serve as a case study in the World Bank's Region Study of Health Finance. Specifically, the study sought to document different types of insurance systems in Zaire, and to conduct in-depth case studies of several schemes. The in-depth case studies presented in this report evaluate the design, management operational efficiency of four health insurance programs from both rural and urban areas. The case studies also attempt to analyze the effects of insurance on equity of access, utilization of health care services, and mobilization of financial resources for the health sector. From these analyses, the report draws conclusions about the advantages and disadvantages of health insurance programs as a means of financing health care services in Zaire, and suggests avenues for future research, policy, and programming initiatives.
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