Community health insurance (CHI) is a specific health insurance arrangement serving a social purpose, generally operating at the local level of the health system, and largely thriving on community solidarity. This article describes the origins, formats, and evolution of CHI in Africa and Asia. It discusses strengths and weaknesses of CHI from different perspectives: its contribution to health-care access, to health sector financing, to provider responsiveness and quality of care, and to wider developmental objectives. The potential of CHI in the worldwide endeavor for universal health coverage and the conditions for CHI to possibly play a role of significance are critically analyzed.
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