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Many low/middle-income countries (LMICs) are increasingly prioritising UHC and reforming their health systems to accelerate progress to achieve this target. To reduce the financial burden of care and improve financial risk protection, many of these countries are turning to public contributory health insurance as a mechanism for removing financial barriers to access and extending financial risk protection to the population.  This study assessed the level and inequality of population coverage of existing health insurance schemes in 36 sub-Saharan Africa (SSA) countries. The results show that of the 36 countries only four countries had coverage levels with any type of health insurance of above 20% (Rwanda—78.7% (95% CI 77.5% to 79.9%), Ghana—58.2% (95% CI 56.2% to 60.1%), Gabon—40.8% (95% CI 38.2% to 43.5%), and Burundi 22.0% (95% CI 20.7% to 23.2%). These four countries’ NHIS are characterised by substantial funding from tax revenues. Whereas, the other study countries with low coverage rates averaging 7% featured predominantly voluntary mechanisms. The implication of the study is that tax funding could be a sustainable and feasible mechanism for mobilising resources for the health sector.
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