The Health Inc project ("Financing health care for inclusion") coordinated by LSE Health was funded by a €2.8 million grant from the European Commission's Seventh Framework Programme. The 42-month project (May 2011-October 2014) explored how social exclusion restricts access to health services despite recent health financing reforms. The project aimed to determine how access to health financing schemes can be improved for vulnerable groups and if different types of financing arrangements can help overcome social exclusion by empowering socially marginalised groups.
Employing a mix of research methods, the team studied related issues in Ghana, India (Karnataka and Maharashtra states) and Senegal. The particular Social Health Protection (SHP) schemes studied were Ghana's National Health Insurance Scheme (NHIS), India's RashtriyaSwasthyaBimaYojana (RSBY) national health insurance scheme for families below the poverty line, and Senegal's Plan Sesame exemption scheme for people aged over 60.
Findings from the project include poor awareness of RSBY and Plan Sesame and low enrolment rates in all three schemes. Furthermore, all schemes disproportionately benefited those who were socially, politically, economically and/or culturally privileged. Numerous exclusionary mechanisms were determined to be drivers of inequities in access to and use of SHP. Notably, the socially excluded themselves identified SHP schemes as something not meant for people like them. Research results point to the need for specific reforms to SHP schemes to make them more socially inclusive. As such, Health Inc developed a set of policy recommendations applicable to the three schemes studied.
Project outcomes have contributed to the international debate and knowledge base on health financing in LMICs. They also enriched research on LMIC health systems, supporting research on social exclusion and the development of policy tools to increase social inclusion. Results should ultimately lead to improved health care access in LMICs.
Health Inc. is a collaboration between LSE Health (project coordinator), the Institute of Tropical Medicine in Antwerp, Tata Institute of Social Science in Mumbai, Institute of Public Health in Bangalore, the Centre for Research on Social Policies in Senegal and the Institute of Statistical, Social and Economic Research in Ghana. For more details please contact Philipa Mladovsky (firstname.lastname@example.org|) or Gemma Williams (email@example.com).
The Health Inc. consortium at LSE for the project launch meeting, 27-29 June 2011.