First published in 1948, the International Social Security Review is the principal international quarterly publication in the field of social security.
In this article, we provide an overview of the current long-term care (LTC) landscape across low- and middle-income countries (LMICs), based on an analysis and synthesis of literature review findings. We begin with a brief assessment of LTC needs on the demand side, followed by a supply side assessment of the available mix of formal LTC services vis-à-vis informal care provision. Next, we describe and discuss the role of government policies in LTC provision and governance. We conclude by discussing and offering practical LTC policy considerations for LMICs, drawing on experiences, best practices and lessons learned from high-income countries.
This article analyses whether and to what extent social protection expenditure varies with institutional quality and people’s preferences using cross-section and cross-country panel data. It uses data on expenditure taken from the International Labour Office database focusing on 52 low- and middle-income countries and on 80 high-, low- and middle-income countries. The results show that both factors have an impact for the group of low- and middle-income countries, but also for all the countries in the sample. The estimates are robust to different definitions of the dependent variables and different measures for the quality of institutions. Our results suggest that it is worthwhile to continue enhancing the capacity of institutions and public authorities as well as to channel people’s preferences on social protection interventions into the planning and budgeting process where the decisions on social protection programmes are taken and resources allocated.
Limited evidence on the design and implementation of social protection programmes for people with disabilities in low- and middle-income countries constrains understanding of how their impacts could be improved. The Disability Allowance programme in the Maldives is a non means-tested, monthly cash transfer targeting people with disabilities. Using qualitative methods, process evaluation was used to examine the intervention design, implementation, and likelihood of achieving its intended objectives. There were important strengths of the programme, including the broad definition of disability. We find that delivery could be strengthened through providing greater clarity on eligibility criteria and strengthening human resources to widen the programme’s reach. Intervention fidelity was challenged by inconsistent practice among implementers and lack of established protocols. Most importantly, the absence of linkages with the Medical Welfare scheme that provides assistive devices potentially limits the likelihood of the programme achieving intended objectives.
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.