Summary (English)

The extension of social security is very urgent for those most exposed to health and accident risks, such as informal economy workers: The World Health Organization (WHO) estimates that every year, 100 million persons enter into a vicious circle of ill health and poverty due to health care costs.

In order to extend social security, policymakers have several options to choose and mix from: Social health insurance, tax-financed universal health care systems, private health insurance, community-based and micro-insurance schemes financed by contributions or taxes. None of them is ideal, as they all have context-related advantages and disadvantages, as indeed the issue of extension is best addressed through customized programs using coherently all the complementarities of these options.

This paper intends to both underline the high potential of coverage extension strategies that build on linkages between various extension mechanisms and to respond to the existing gap of both empirical and conceptual considerations on linkages.
It focuses on statutory social security (SSS) schemes and community-based social protection (CBSP) mechanisms in order to develop a typology of potentially promising linkages between these types of mechanisms. Both SSS schemes and CBSP mechanisms have each their specific advantages and disadvantages in terms of their capacity to cover different types of population groups in developing countries. Linking the two in order to compensate for their respective weaknesses and to exploit their respective strengths therefore appears to have important potential.
And indeed, this paper provides innovative empirical examples on some of these types of linkages based on a joint ILO/ISSA/AIM study covering a number of countries in three regions. Country reports are accessible on the ISSA Extranet site and the ILO/GIMI platform.

Note

The typology is based on 10 case studies on the linkages between SSS scheme and CBSP mechanism that exist in 10 different countries namely Argentina, Burundi, China, Colombia, Ghana, India, Lao PDR, Philippines, Rwanda, Uruguay.