First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
To support the improved administration of social security programmes, this article presents a preliminary compliance risk management (CRM) model for social security institutions to use as a tool to help address the operational challenges of error, evasion and fraud. Within the model, error, evasion and fraud are collectively referred to as issues of non‐compliance. The model's framework addresses non‐compliance in an integrated manner with regard to the main functions of contribution collection and benefit administration. The model aims to facilitate tackling these important issues by better permitting the identified challenges to be prioritized and, thereafter, addressed based on the assessed severity of their impacts and the cost‐effectiveness of the selected responses. Three generic types of intervention are recommended to tackle non‐compliance worldwide: prevention, detection and deterrence. The article's objective is to contribute to ongoing work to develop an encompassing CRM framework for all social security systems.
This article assesses the effectiveness of pension provision and health insurance in preventing ill health among older people in developing countries. It argues that, until recently, social protection agendas devoted insufficient attention to health risk prevention, instead focusing on the reduction of income poverty through cash transfers. The article shows that there is little reliable evidence to indicate that providing older people with pension benefits enhances their health status and that these effects should not be taken for granted by policy‐makers. The article then focuses on the effect of inclusion in health insurance schemes on health outcomes for older people, with specific reference to outcomes related to hypertension. Drawing on newly‐available data from the World Health Organization for Ghana, Mexico and South Africa, it shows that older people with health insurance are marginally more likely to be aware of health conditions such as hypertension and more likely to have them under control. Nevertheless, the great majority of hypertensive older people, insured or uninsured, are not effectively treated. The chief barriers to treatment are shown to be mainly related to awareness and service provision, rather than financial ones. Consequently, the capacity of pensions or health insurance to enhance health outcomes for older people in such countries, including in rural areas, is heavily contingent upon health education, health screening and adequate health service provision. These interventions should be viewed as an integral element of mainstream social protection strategies, rather than adjuncts to them. Yet, in practice, social protection and health promotion continue to be treated as almost entirely separate spheres, thus presenting substantial institutional barriers to developing combined interventions.