A study by colleagues from ACCESS Health International was recently published in the esteemed Economic and Political Weekly (EPW). Titled “Extending Health Financial  Coverage to the Informal Non-poor and Near Poor in India: An Explanatory Study”, the study is co-authored by Dr Krishna Reddy Nallamalla, Anuradha Katyal, Girish Bommakanti, Anju Aggarwal and former AHI colleague Prashanthi Krishnakumar.

The study is based on the review of literature on the lessons learnt by extending health insurance coverage to the informal non-poor, globally. The research explored successful insurance coverage programs such as community-based health insurance and government-sponsored health insurance schemes in India and other countries like China, Mexico, and The Philippines among others, identifying key lessons on policy design, stakeholder engagement, and addressing barriers to access. A “missing middle” comprising non-poor informal workers, middle-class workers and their families, who are not covered by these schemes, remain financially vulnerable due to healthcare episodes.The research aimed to understand and address the challenges faced by informal workers in accessing insurance coverage.

Research findings revealed that successful programs require well-designed policies, robust institutional mechanisms, and adequate financial resources. The optimal contributory or non-contributory models need to be determined, considering the unique needs of informal workers in different contexts. Engaging with informal workers to understand their needs and preferences is crucial for program design and implementation.

The EPW is a renowned publication known for its rigorous standards and contribution to evidence-based policy discussions. This publication underscores the commitment of the AHI team commitment to policy research to strengthen health systems to secure healthcare for all people.

InOrder is a strategic associate and research partner of AHI and acknowledges  the team members for their diligent efforts in data collection, analysis, and interpretation, as well as their valuable inputs and contributions to the article. It is hoped that the research findings will inform policymakers, practitioners, and researchers in their efforts to enhance insurance coverage for informal workers in India.

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