The decentralization of the NHIS’s implementation to states intended to hasten progress towards universal health coverage, has not effectively addressed healthcare disparities, particularly in Lagos State. The implementation of the Lagos State Health Insurance Scheme appears to perpetuate structural violence, evident in increased out-of-pocket expenses, discrimination based on insurance type, and substandard healthcare delivery. The study therefore examined how structural violence has affected the policy outcomes of the Lagos State Health Insurance Scheme, with a specific emphasis on junior officers in grade level 01–07 in five selected ministries situated within Lagos State. Both primary and secondary data were collected using questionnaire, interview and literature search. Data gathered were analysed statistically and thematically. The findings of the study indicate that the policy outcome of the scheme has been adversely affected by structural violence, resulting in dissatisfaction, compensation claims for unresolved health issues and a shift in health insurance providers among enrolled junior officers.

Low enrollment intention threatens the funding pools of rural insurance schemes in developing countries. The purpose of this study is to investigate how social capital enhances the enrollment of health insurance among rural middle-aged and elderly. We propose that social capital directly increases health insurance enrollment, while indirectly influences health insurance through health risk avoidance. We used data from the China Health and Retirement Longitudinal Study (wave 4) dating the year of 2018, instrumental variable estimation was introduced to deal with the endogeneity problem, and the mediation analysis was used to examine the mechanism of social capital on insurance enrollment. The results show that social capital is positively related to social health insurance enrollment, and the relationship between social capital and social health insurance enrollment is mediated by health risk avoidance.

This study aims to identify gaps in Indonesia’s national social health insurance scheme (Jaminan Kesehatan Nasional or JKN) in meeting the right to health for disabled persons in the country and to propose strategies to mitigate the gaps. This study employed descriptive qualitative methodologies. A questionnaire survey and structured interviews were undertaken from the period of October to December 2021, with a purposive sample of 317 disabled persons at their working age. Data collection also included on-site observations to sample of healthcare providers in six provinces and focused group discussions with key stakeholders. This study found that JKN is the primary source of hope for disabled persons. Nevertheless, approximately ten percent of disabled persons have been omitted from the scheme. Moreover, respondents of the survey expressed notably lower satisfaction level compared to the national average. Meanwhile, 25% of them also reported that JKN did not cover certain disability-specific benefits. The findings suggest that the national social health insurance scheme is not well prepared to offer disability-inclusive services. Thereby, policymakers should implement various interventions to improve the admission processes for disabled persons and to develop a system to identify disabled members based on their specific disabilities. Additionally, stipulating standards for disability-friendly minimum services for healthcare providers and incorporating the standards into the credentialing systems, providing regular training on disability-friendly services for healthcare personnel, also enhancing benefits coverage for disabled members in the Indonesian Case Base Groups (INA-CBGs) are the necessary strategies to mitigate the gaps.

Universal Health Coverage is a health insurance system that ensures every citizen in the population has equitable access to quality and effective promotive, preventive, curative, and rehabilitative health services. Meanwhile, the Medan City Government of Indonesia is trying to improve health services through the Medan Berkah Health Insurance Program by adopting Universal Health Coverage, which aims to provide Universal Health Coverage to the entire community. This study aims to explain the implementation and projection of the development of health services of the Medan City Government with the Universal Health Coverage System in the Medan Berkah Health Insurance Program which is intended as a step in providing opportunities for all people to get equal opportunities in health services, especially for the poor. This research uses qualitative research by using the literacy study method by studying related documents and conducting in-depth observations. Data analysis included data reduction, presentation, and conclusion drawing. The Medan City Government implemented the Universal Health Coverage Program in Jaminan Kesehatan Medan Berkah, which aims to improve health services in the city. The government is committed to simplifying the bureaucracy, managing the medical workforce, and collaborating with stakeholders and the community. However, challenges include low community participation, limited resources, lack of coordination, and limited access to information, which hinder the successful implementation of the program.

Many previous studies find no significant effect of health insurance on health outcome in rural areas of China. Many researchers believe this could be because of the characteristics of health care provision in those areas. In this paper, we aim to examine if urbanization will change the situation. Our research question focuses on if urbanization will change the participation and performance of health insurance on health outcome in a positive direction. Using a longitudinal sample drawn from the China Health and Nutrition Survey (CHNS), we employed multiple estimation strategies for multiple waves to handle the potential selection bias. We find that urbanization factors such as population density, transportations and housing are associated with probability of insurance participation. That is, urbanization related factors tend to increase people’s willingness of insurance participation. We also conclude that urbanization improves the performance of insurance on self-reported health outcome. Results show that the health insurance has a significant positive impact on health production in urbanized areas. Health insurance in general increases the probability of health care utilization for all areas. However, it does not lead to a significant improvement in the health outcomes in under urbanized areas because of the health provision quality or characteristics of health insurance coverage in those areas.