CONTRIBUTORY SOCIAL PROTECTION FOR THE INFORMAL ECONOMY? Insights from Community-Based Health Insurance (CBHI) in Senegal and Tanzania

Social protection occupies an important place on the international agenda. A growing number of low- and middle-income countries are in the midst of a ‘quiet revolution’, whereby they are integrating social protection into national development strategies (Barrientos & Hulme, 2009). This evolution is supported by international institutions like the World Bank and the ILO, who, in 2015, launched a global partnership for universal social protection (Zelenev, 2015). Yet in many of these countries, the achievement of universal social protection remains a massive challenge. According to the ILO (2017), only 29 percent of the global population enjoys access to comprehensive social protection, while the remaining 71 percent are not or only partially covered. In addition to being underfinanced and fragmented, existing systems of social protection continue to focus on those in formal employment, while excluding the majority that depends on the informal economy (Alfers et al., 2017). This coverage gap is highly worrisome, because people in the informal economy are disproportionately at risk from employment-related health- and income shocks (Chen, 2008)...