Health financing for universal coverage

Reaching universal coverage by means of social health insurance in Lesotho? Results and implications from a financial feasibility assessment

International Social Security Review, volume 64, issue 2

Mathauer I, Doetinchem O, Kirigia J, Carrin G

Publication details

Number of pages: 45-63
Publication date: April 2011
Languages: English


  • Full article
    Wiley Online Library. DOI: 10.1111/j.1468-246X.2011.01392.x


This article discusses the process, results and implications of a financial feasibility assessment of social health insurance (SHI), as one part of Lesotho’s exploration of how to move towards achieving universal health care coverage. Quantitative data from government and other sources, and qualitative data from discussions with stakeholders, were entered into SimIns, a health insurance simulation software, through which SHI revenue and expenditure for 11 years was projected.

In principle, the assessment reveals that through a mix of tax financing and SHI contributions, all citizens of Lesotho could be covered with a defined benefit package of health services under the defined policy assumptions. Such a financing scheme would provide financial risk protection and enhance equity in access and health financing.