Cogent Economics & Finance

Healthcare Financing in Emerging and Developing Economies: Insurance, Revenue Mobilization, and Financial Protection

Healthcare financing — the mechanisms by which individuals, households, governments, and markets raise, pool, and allocate resources for health — sits at the heart of efforts to achieve universal health coverage and improve health outcomes in the developing world. In low- and middle-income countries, the structure of health financing determines whether the poor receive care, whether households are protected from financial catastrophe, and whether health systems can attract the investment needed for sustainable delivery. Yet healthcare financing in these contexts is deeply shaped by forces that extend beyond health economics proper: the development of insurance markets, the depth of financial systems, the penetration of digital financial services, the capacity of fiscal systems for domestic resource mobilization, and the governance of public spending. This Article Collection brings together rigorous research at the intersection of health economics, financial economics, and development economics to advance understanding of how healthcare is financed in emerging and developing economies.

Despite decades of commitment to universal health coverage, healthcare financing remains the primary barrier to equitable health access across much of the developing world. Out-of-pocket payments account for more than 40% of total health expenditure in over half of low- and middle-income countries, pushing millions into poverty annually. Public health expenditure per capita in sub-Saharan Africa averages a fraction of what high-income countries spend, reflecting both weak fiscal capacity and political economy constraints on health budget allocation. Community-based and social health insurance schemes have expanded coverage but face chronic sustainability challenges rooted in financing design, adverse selection, and weak contribution compliance. Meanwhile, the emergence of mobile money, digital financial services, and fintech platforms is creating new possibilities for premium collection, risk pooling, and reduction of payment friction in low-resource settings. Evidence-based insights into what financing mechanisms work, for whom, and under what conditions are urgently needed to inform policy.

This Article Collection invites original empirical and theoretical contributions across the following interconnected themes: the design and reform of health financing systems in developing economies; social health insurance, community-based insurance, and private voluntary insurance markets; out-of-pocket expenditure, catastrophic health spending, and household financial protection; domestic resource mobilization, health taxation, and fiscal space for health; the role of financial inclusion, mobile money, microfinance, and digital finance in improving health financing; the political economy of health financing reform; equity dimensions of health financing incidence and benefit analysis; and the macroeconomic and development finance determinants of health expenditure. Studies using rigorous quantitative methods including natural experiments, difference-in-differences, instrumental variables, regression discontinuity, and panel econometrics are particularly encouraged. The Collection especially welcomes contributions from and about Africa, South Asia, and other developing regions, and from interdisciplinary perspectives bridging health economics, financial economics, and development economics.

Please contact Dr. MK Huffman at [email protected] with any queries about discount codes regarding this Article Collection.

Please also be sure to select the appropriate Article Collection from the drop-down menu in the submission system, and select the section "Health Economics."

Dr. Kwadwo Arhin holds a Doctor of Philosophy (Ph.D.) in Economics and a Master of Arts (M.A.) in Economics, both conferred by the Kwame Nkrumah University of Science and Technology (KNUST), Kumasi, Ghana. He currently serves as a Senior Lecturer within the Department of Economics Education, Faculty of Education, at the University of Skills Training and Entrepreneurial Development (USTED). Dr. Arhin is also recognized as a Fellow of the esteemed Center for Effective Global Action (CEGA) at UC Berkeley, United States. Furthermore, he holds a certificate in Designing and Running Randomized Evaluations from the Massachusetts Institute of Technology (MIT). His research areas include Health Economics and the Economics of Education, with a particular focus on healthcare financing, health system efficiency, and the impact evaluation of educational programs.

Dr. Arhin declares no conflicts of interest regarding this work.