Skip to Main Navigation

Using proxy-means testing to expand health insurance for the poor (Russian)

Colombia's poor now stand a chance of holding off financial catastrophe when felled by serious illness. Sweeping health sector reform in 1993 brought health insurance to people never before covered. It used a proxy means testing instrument, known as system for Selecting Beneficiaries of Social Spending (SISBEN, in Spanish) to assess the living conditions of individual families. SISBEN has established a technical, objective, equitable and uniform mechanism for selecting beneficiaries of social spending to be used by all government levels. It classified applicants to social programs in a rapid, uniform and equitable way. It strengthened institutional development of municipalities with the establishment of a modern social information system and supported inter-institutional coordination within the municipality to improve the impact of social spending. It avoided duplication and concentrated efforts on the poorest. It elaborated socioeconomic diagnostics of the poor population to better prepare the social insurance programs for the poor, and facilitated attainment of targeting goals for the various levels of governments.This paper includes the following headings: a health system built on myths pre-1993; differences between rich and poor; the 1993 health sector reform; the results; and the challenges ahead.


  • Document Date


  • Document Type


  • Report Number


  • Volume No


  • Total Volume(s)


  • Country


  • Region

    Latin America & Caribbean,

  • Disclosure Date


  • Disclosure Status


  • Doc Name

    Using proxy-means testing to expand health insurance for the poor

  • Keywords

    access to health care, access to health care services, adverse selection, ambulatory care, care during pregnancy, child birth, child delivery, child mortality, clinics, crowding, elderly, employment, expenditures, families, financial catastrophe, financial protection, financial resources, financial risk, free care, health care, health care access, health care delivery, Health care expenditure, health care financing, health care system, health care systems, health care use, Health Insurance, health interventions, health reform, health sector, health sector reform, health service, health services, health status, Health System, hospitalization, hospitals, human capital, illness, income, income groups, infant, infant mortality, Infant Mortality Rate, infant mortality rates, information system, Inpatient Care, insurance premiums, Latin American, live births, living conditions, maternal health, medical bills, medical care, medical center, medical services, Ministry of Health, mortality, national health, Nutrition, patients, physician, Policy makers, poor people, pregnancy, prenatal care, preventive care, private health care services, private hospitals, private insurance, private sector, private sectors, public health, public health care, public health services, public hospitals, public sector, public services, quality control, quality of health, quality of health care, rural areas, rural population, rural women, Selection System, service quality, single mothers, social information, social insurance, Social Programs, social security, social security schemes, universal health insurance coverage, workers



Official version of document (may contain signatures, etc)

  • Official PDF
  • TXT*
  • Total Downloads** :
  • Download Stats
  • *The text version is uncorrected OCR text and is included solely to benefit users with slow connectivity.


Using proxy-means testing to expand health insurance for the poor (Russian). Reaching the poor with health services ; Colombia Washington, D.C. : World Bank Group.