Strategies for Health Insurance Mechanisms to Address Health System Inequities in Ghana, South Africa, and Tanzania

Over the past two decades, African governments have promoted the growth of private health care as a key element of health sector reform. This trend has contributed to health system inequities and exacerbated the plight of the poor. For example, the movement of health professionals to the private sector has limited the ability of the public sector to meet the needs of the population dependent on its services. This leads to a decline in the quality of care offered by public facilities, such that even the poorest turn to private for-profit providers, further depleting scarce household resources.

This project will critically examine existing inequities in the health systems of Ghana, South Africa and Tanzania. The results will inform alternative approaches to health insurance as a mechanism for addressing health system inequities and achieving the Millennium Development Goals. The emphasis will be on mandatory insurance and on insurance mechanisms for covering those outside formal employment. The project will form the basis for a larger three-year project that has been short-listed for support by the European Union.

Project ID


Project status


Start Date

Thursday, March 30, 2006

End Date

Sunday, April 1, 2007


18 months

IDRC Officer

Ingabire, Marie-Gloriose

Total funding

CA$ 334,800


Ghana, Tanzania, South Africa, South of Sahara


Maternal and Child Health

Project Leader

Mshinda, Hassan


Ifakara Health Institute

Institution Country


Institution Website

Project Leader

McIntyre, Diane


University of Cape Town

Institution Country

South Africa

Institution Website

Project Leader

Gyapong, John


Ghana Health Service

Institution Country