Social insurance in the global south: the case of India

Social insurance, especially for health, has seen unprecedented attention in developing countries in the last few decades. With growing realization about the macro-economic growth’s
inability to reduce poverty and the public health system’s ineffectiveness to protect millions
being driven into poverty every year due to catastrophic healthcare expenditures, many
developing countries are exploring options beyond supply-side approaches to health security.
Further development of private insurance markets and pressure from civil society groups
and international financial institutions to reduce glaring health inequalities led to critical realignments that steered governments to pursue demand-side approaches such as social health insurance to provide health security to low-income and informal sector workers in many developing countries including India. Given the important role these programmes have played in improving health insurance coverage in the last two decades in the Global South, this chapter provides an overview assessment of these programmes in the Global South taking a case from India. We assess the development of these programmes including the factors that have driven the growth of these programmes in the Global South drawing from theories of public policy. We also link our findings with the experience of similar programmes in other developing countries, identifying the future research needs for improving
effectiveness of SHI in the Global South.