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The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam - P4H Network

The inclusion of diagnostics in national health insurance schemes in Cambodia, India, Indonesia, Nepal, Pakistan, Philippines and Viet Nam

Access to diagnostic testing, particularly basic tests at the primary care level, exhibits a notable disparity within low-income and middle-income countries (LMICs). It is crucial for these countries to incorporate diagnostics into their universal health coverage benefits packages.
Inclusion of diagnostic testing under health benefits packages could reduce the financial burden associated with out-of-pocket payments for healthcare, while enhance health care access.

This study undertook a focused literature review and employed a health financing framework to analyze benefit packages within government-sponsored schemes across seven Asian LMICs: Cambodia, India, Indonesia, Nepal, Pakistan, Philippines, and Viet Nam.

Among these countries, only India has established a national essential diagnostics list. Notably, none of the countries provided a clear policy rationale for the inclusion of diagnostics in their schemes, and the specifics of covered diagnostics were generally lacking in detail.

While government-sponsored insurance has mitigated out-of-pocket health payment burdens for eligible populations, there remains a pervasive deficiency in access, availability, and affordability of diagnostic-related services.

Reference