Health insurance (HI) has become a central policy tool in the Middle East and North Africa (MENA) region as countries work toward universal health coverage (UHC). Despite the dominance of government funding and out-of-pocket (OOP) spending in financing health care, a growing number of MENA countries are introducing or expanding compulsory HI schemes. This shift reflects not only the ambition to protect populations from financial hardship but also the recognition that sustainable and equitable health systems require diversified financing mechanisms. However, evidence from low- and middle-income countries (LMICs) suggests that HI on its own may have a limited impact if not carefully designed and implemented.
This World Bank landscape assessment provides a comprehensive overview of the current status of HI in MENA. It examines the motivations driving reforms, key design and implementation features, and the challenges countries face in aligning HI with broader UHC goals. The report also offers practical recommendations to help governments maximise the potential benefits of HI while ensuring financial protection, equity, and efficiency in health financing.