Budget Survey Research Articles

Banning fossil fuel cars and boilers in Switzerland: Mitigation potential, justice, and the social structure of the vulnerable

Despite many policy instruments to mitigate climate change, literature on distributional justice has mainly focused on carbon taxes. We focus on two regulatory instruments that could speed up climate change mitigation in Switzerland: banning the use of fossil fuel cars and boilers in the residential sector. By merging data from Swiss Household Budget Survey, Mobility and Transport Microcensus, and Swiss Household Energy Demand Survey, we quantify the mitigation potential and distributional justice of various ban designs. We find that, in general, the bans that target more emissions are more egalitarian (i.e. achieve a more equal distribution of vulnerabilities), but less just under the utilitarian, Rawlsian difference, and sufficientarian principles. Under these three principles, the best compromise between mitigation potential and justice is to include exemptions for the lowest income households. An alternative could be more ambitious bans to maximize mitigation potential while compensating for the most vulnerable households. For selected ban designs, we identify which household groups would be most vulnerable and retrieve specific cases of hardship.

Assessing the Impact of Covid-19 in Mozambique in 2020

Taking advantage of the 2019/2020 Mozambican household budget survey, in the field both before and during the first phases of the Covid-19 pandemic, we assess the impact of Covid-19 on welfare in 2020, aiming to disentangle this impact from the effect of other shocks. Comparing a number of welfare metrics, and applying propensity score matching and inverse probability weighted regression adjustment approaches, we find that consumption levels are significantly lower and poverty rates substantially higher during the first phases of Covid-19 than in the pre-Covid-19 period. Moreover, the impact was greater in urban areas and accordingly in the more urbanised southern region. Non-food expenditures suffered relatively more than food expenditures, likely a coping strategy, while the impact on consumption levels was greater for people working in the secondary and tertiary sectors than for workers in the primary sector, mainly agriculture. Stunting among under-5 children also suffered. Only a limited number of countries have actual, collected in-person, survey data that span across the initial phases of the Covid-19 pandemic. Thus, the present analysis adds value to our understanding of the welfare consequences of Covid-19 in a low-income context, where automatic social safety nets were not in place during the early phases of the pandemic. More specifically, it helps in assessing the results of previous welfare impact simulations, compared to real data. Even though our main findings are broadly in line with existing estimates based on simulations or phone surveys, important differences between the predictions and the actual results emerge. We conclude that it is critically important for Mozambique and its development partners to develop stronger and more targeted policies and tools to respond to temporary shocks.

Does a household’s income affect its carbon emissions? Results for single-family homes in Poland

A key challenge of Fit for 55 will be reducing household emissions. For this, it is necessary to understand the factors that influence emissions and the specific role of household income. This study tests the validity of the environmental Kuznets curve (EKC) for households and links carbon emissions with income, housing, energy sources, and hidden energy poverty. We use individual household data from the Polish energy consumption survey complemented with data from a budget survey both compiled by Statistics Poland. The EKC is estimated in two scenarios, i.e. current energy mix, and zero-carbon electricity. Our model is based on the least trimmed squares technique. The study confirms the existence of the inverted U-shaped EKC in households, which is especially relevant for owners of small houses. This finding might be explained by the energy under-consumption often experienced by the poorest households, whereas wealthier households usually live in energy-efficient buildings and use less carbon-intensive fuels. The turning point is reached at 373 euros of income and 3425 kg of carbon emissions in a usual energy mix scenario compared to 560 euros and 5104 kg in a clean electricity scenario. Apart from income, household carbon emissions are interrelated with house size and hidden energy poverty, which should be in policymakers focus.

Dwelling, Habits, and Possessions: Clustering Turkey’s Household Energy Choices through Responsible Consumption and Poverty

Household energy consumption is influenced by a variety of factors, including climate, demographics, and socio-economic conditions. This study is a review based on clustering analysis of data from the 2019 Household Budget Survey in Turkey, and explores the role of dwelling structure, household habits, and possessions as indicators of energy patterns and preferences within distinct household groups contributing to Sustainable Development Goals 1, 7, and 12. The data analysis identifies three distinct clusters with specific features that set them apart. The Urban Majority cluster represents densely populated urban areas where natural gas is a preferred fuel source, and parquet and ceramic tiles are common flooring materials. The Deprived-like Remote Residents cluster portrays areas with less access to natural gas, where wood and coal are frequently used for heating, and the Urban Comfort-Seekers cluster highlights urban areas with high comfort levels, featuring natural gas, floor heating, and various amenities. These clusters reflect energy consumption patterns and social aspects related to poverty and habits. They indicate that Turkey’s energy preferences are closely linked to accessibility, user-friendliness, and affordability. Urban households prioritize comfort, while rural areas are more resource-constrained, and contextual factors like location and possessions play a vital role in energy preferences.

Answering Current Challenges of and Changes in Producing Official Time Use Statistics Using the Data Collection Platform MOTUS

Abstract The modernization of the production of official statistics faces challenges related to technological developments, budget cuts, and growing privacy concerns. At the same time, there is a need for shareable and scalable platforms to support comparable data, leading to several online data collection strategies being rolled out. Time Use Surveys (TUS) are particularly affected by these challenges and needs as they (while producing rich data) are complex, time-intensive studies (because they include multiple tasks and are administered at the household level). This article introduces the Modular Online Time Use Survey (MOTUS) data collection platform and explains how it accommodates the challenges of and changes in the production of a TUS that is carried out in line with the Harmonized European Time Use Survey guidelines. It argues that MOTUS supports a shift in the methodological paradigm of conducting TUS by being timelier and more cost efficient, by lowering respondent burden, and by improving the reliability of the data collected. Importantly, the modular structure allows MOTUS to be easily deployed for various TUS configurations. Moreover, this versatile structure allows comparable, complex diary surveys (such as the household budget survey) to be performed on the same platform and with the same applications.

The impact of health crisis on sports consumption – A longitudinal study

This research identifies the impact of the COVID-19 pandemic and compares it with the pre-pandemic year of 2019 on leisure sports consumption patterns among Spanish families from the gender perspective. The study analyses longitudinal official open massive data collected from the Spanish Family Budget Survey (2019–2020) to create market segmentations based on gender, year, age, and sociocultural level variables. The study's findings reveal stereotypes in leisure sports expenditure based on the gender of the household earner. In 2020, spending on leisure sports increased to a record high of 176%, with spending by men drastically lower and women considerably higher than in 2019.

Assessing equity and efficiency of health financing towards universal health coverage between regions in Tanzania

Equity and efficiency in health financing are intermediate universal health coverage (UHC) objectives. While there is growing attention to monitoring these goals at the national level, subnational assessment is also needed to uncover potential divergences across subnational units. We assessed whether health funds were allocated or contributed equitably and spent efficiently across 26 regions in Tanzania in 2017/18 for four sources of funding. Government and donor health basket fund (HBF) expenditure data were obtained from government authorities. Household contributions to health insurance and out-of-pocket payments were obtained from the national household budget survey. We used the Kakwani index (KI) to measure regional funding equity, whereby regional GDP per capita measured regional economic status. Efficiency analysis included four financing inputs and two UHC outputs (maternal health service coverage and financial protection indices). Data envelopment analysis estimated efficiency scores. There was substantial variation in per capita regional funding, especially in insurance contributions (TZS 473–13,520), and service coverage performance (49–86.3%). There was less variation in per capita HBF spending (TZS 1294–2394) and financial protection (93.5–99.4%). Government spending (KI: -0.047, p = 0.348) was proportional to regional economic status; but HBF spending (KI: -0.195, p < 0.001) was significantly progressive (equitably distributed), being targeted to regions with high economic need (poor). The burden of contributing to social health insurance (NHIF) was proportional (KI: 0.058, p = 0.613), while the burden of paying for community-based insurance (CHF, KI: -0.152, p=0.012) and out-of-pocket payments (KI: -0.187, p=0.005) was higher among the poor (regressive). The average efficiency score across regions was 90%, indicating that 90% of financial resources were used optimally, while 10% were wasted or underutilised. Tanzania should continue mobilising domestic resources for health towards UHC, and reduce reliance on inequitable out-of-pocket payments and community-based health insurance. Policymakers must enhance resource allocation formulas, public financial management, and sub-national resource tracking to improve equity and efficiency in resource use.

Progress in the fight against malnutrition in Mozambique: A review of policies, action plans, and nutritional intervention programs

Malnutrition is a public health problem in Mozambique, where 37% of children under five suffer from chronic malnutrition and 4% from acute malnutrition. Since national independence in 1975, action plans have been implemented to reverse this situation. Objective: To analyze the progress made in the fight against malnutrition through the policies, action plans and programmes implemented in the country since independence. Methodology: Documentary study, whose main data sources consisted of Demographic and Health Survey reports, Family Budget Surveys, SMART Surveys, Integrated Classification of Food Security Stages reports, information from FAO databases, as well as other studies on the nutritional situation in the country. The WHO and UNICEF classifications were used to describe the prevalence rates of malnutrition. Results: Except for acute malnutrition, which reduced from high to low between 1997-2023, the prevalence of chronic malnutrition had no statistically significant reductions and remains very high. Factors such as food insecurity, high illiteracy rates, armed conflict in northern Mozambique, poverty, unequal distribution of basic resources between provinces, weak monitoring and evaluation systems in the action plans implemented, poor investment in agriculture, covid-19, as well as the effect of climate change, which constantly affects the country, are the main causes. Conclusion: Despite efforts, malnutrition continues not to show significant reductions, which calls for further study and improvement of policies, as well as the control of risk factors.

The carbon footprint of the empty Castilla-La Mancha

In this paper, we analyze the carbon footprint of Castilla-La Mancha households, a region of the so-called “empty Spain,” and their mitigation potential. For this purpose, we use the environmentally extended multiregional input-output model and the Spanish Households Budget Survey to extract expenditure microdata by municipality size. We find that households in smaller municipalities have a larger total carbon footprint due to their higher direct emissions. Although their consumption is lower than other municipalities, they have a more intensive pattern of embedded carbon consumption. Households in smaller municipalities spend a higher share in private transport and housing-related activities, emitting almost an additional ton of direct carbon emissions.Regarding their mitigation potential, results show that for every euro that municipalities with less than 10,000 inhabitants reduce their consumption, they would reduce emissions by 0.796 kgCO2. However, while the size of the municipality increases, the mitigation potential decreases (0.378 kgCO2 for more than 100,000 inhabitants). This highest mitigation potential will only be achieved if mitigation policies especially favor their inhabitants and if infrastructures and social services are developed to facilitate a change in their consumption patterns.

Price elasticity of demand for ready-to-drink sugar-sweetened beverages in Brazil.

The taxation of sugar-sweetened beverages is a policy that has been adopted in many countries worldwide, including Latin American, to reduce sugar consumption. However, little is known about how taxation on these products may affect their demand. The present study aims to estimate the price elasticity of demand for sugar-sweetened beverages in Brazil. This study advances the literature by proposing a breakdown between ready-to-drink sugar-sweetened beverages and sugar-sweetened beverages that require some preparation before being consumed. With this disaggregation, it is possible to obtain more accurate elasticities for the group of products that will be effectively taxed. We estimated a Quadratic Almost Ideal Demand System (QUAIDS) model using the Household Budget Survey 2017-2018 microdata. The results show that ready-to-drink beverages is more consumed but less sensitive to changes in price than prepared beverages. The price elasticity of demand for ready-to-drink and prepared sugar-sweetened beverages was -1.19 and -3.38. Additionally, we observe heterogeneity in these price elasticities across household incomes, with a more elastic demand among lower-income households for ready to drink beverages. The findings suggest that taxing ready-to-drink sweetened beverages could potentially reduce sugar consumption directly through a decrease in the consumption of sugary drinks and this effect could be reinforced by reducing the consumption of other sugar-rich products. Therefore, the taxation police should effective contribute to minimize health risks associated to the sugar consumption.

The current and future costs of colorectal cancer attributable to red and processed meat consumption in Brazil

BackgroundCompelling evidence supports the association between red and processed meat consumption and increased risk of colorectal cancer. Herein, we estimated the current (2018) and future (2030) federal direct healthcare costs of colorectal cancer in the Brazilian Unified Health System attributable to red and processed meat consumption. Considering reduced red and processed meat consumption, we also projected attributable costs of colorectal cancer in 2040.MethodsWe retrieved information on red and processed meat consumption from two nationally representative dietary surveys, the Household Budget Survey 2008–2009 and 2017–2018; relative risks for colorectal cancer from a meta-analysis; direct healthcare costs of inpatient and outpatient procedures in adults ≥ 30 years with colorectal cancer (C18-C20) from 2008–2019 by sex.ResultsAttributable costs of colorectal cancer were calculated via comparative risk assessment, assuming a 10-year lag. In 2018, US$ 20.6 million (8.4%) of direct healthcare costs of colorectal cancer were attributable to red and processed meat consumption. In 2030, attributable costs will increase to US$ 86.6 million (19.3%). Counterfactual scenarios of reducing red and processed meat consumption in 2030 suggested that US$ 2.2 to 11.9 million and US$ 13 to 74 million could be saved in 2040, respectively.ConclusionRed and processed meat consumption has an escalating economic impact on the Brazilian Unified Health System. Our findings support interventions and policies focused on primary prevention and cancer.

Using labelling information to evaluate the distribution of food additives in products marketed in Brazil

Food additives are ingredients added to food and beverages in order to modify physical, chemical, biological or sensory characteristics, contributing to the development of products that are safer and more convenient and attractive. Although they are widely used by food industries, little is known about the distribution of the food additives currently employed in products marketed in Brazil. Therefore, this study aimed to use labelling information of commercial food and beverages in order to identify the substances currently used by the Brazilian industry. For this, 3300 labels of 426 food items described in the Personal Food Consumption module of the Household Budget Survey (POF 2017/2018) of the Brazilian Institute of Geography and Statistics (IBGE) were searched on websites of supermarket chains and food companies as well as by visits to commercial establishments. According to the ingredient lists of the evaluated samples, 186 distinct food additives were identified. The average number of declared substances per product was between 4 and 5, with most of the labels indicating the presence of 2 or 3 additives. Considering the identified substances, 93 had an Acceptable Daily Intake (ADI) not specified or not limited and 89 were additives with a numerical ADI. Citric acid and lecithin were the most frequent substances with ADI not specified or not limited while potassium sorbate and pentasodium triphosphate were the most frequent food additives with numerical ADI. The most frequent combinations found in the evaluated samples were of potassium sorbate and citric acid, and also sodium nitrite, sodium erythorbate, and sodium diphosphate. This study demonstrates the distribution of food additives in products marketed in Brazil, allowing the creation of a comprehensive and unprecedented database, which will contribute to the evaluation of usage trends and future exposure studies for health risk assessment.

The German Environmental Tax Reform: a difference-in-differences analysis of its impacts in European comparison

AbstractIn 1998, the red-green Schröder government implemented the Environmental Tax Reform (ETR), raising taxes on petrol, diesel, natural gas and heating oil and introducing a new duty on electricity in Germany. At the same time, it cut non-wage labour costs by reducing public pension contributions. The goal was to achieve Germany’s Kyoto Protocol emissions targets and to reduce a level of unemployment unprecedented since World War II while avoiding the burden on the public budget through revenue recycling. Employing microdata from household budget surveys of 1998 and 2003, this article analyses whether increased duties on motor fuels and electricity lead to a substantial reduction in households’ consumption of these goods. Considering the ETR as a natural experiment, it uses the difference-in-differences approach in a European context with Germany as the treatment group and Italy, Spain and the UK as the control group. Ordinary least square regressions reveal that motor fuel demand is price inelastic, while electricity consumption increased despite the substantial rise in prices. Quartile regressions show that the effect of the motor fuel tax is slightly higher at the bottom than at the upper tail of the distribution supporting the notion that low-level consumers are more likely to find alternative substitutes.

Analysing the determinants of the Turkish household electricity consumption using gradient boosting regression tree

Residential buildings are the second largest electricity consumer in Turkey. Thus, the goal here is to detect the factors that determine the electricity consumption of the households in Turkey using the Household Budget Survey (HBS). This study applies Decision Tree (DT), Random Forest (RF) and Gradient Boosted Regression Tree (GBRT) methods. Since the GBRT method provides the lowest Root Mean Squared Error (RMSE), the impact of each variable on the electricity consumption is analysed with this method. The most critical determinant is found to be the household size, while income level and heating type are discovered as 2nd and 3rd most prominent determinants for household electricity demand. With the help of the Partial Dependence Plots (PDP) provided by the GBRT method, the impact of each categorical and continuous variable is presented. Using the results of PDPs, the monetary values of both electricity generation and the social cost of CO2 emissions emitted into the atmosphere due to electricity generation are calculated for the most important determinants.

Effect of the East African Community Common External Tariff on Household Labor Income in Kenya

This study investigates how changes in prices caused by the adoption of the East African Community Common External Tariff affected the labor incomes of households in Kenya. Households in rural, urban, and fully urban areas are analyzed. Workers are classified as skilled versus unskilled, formal versus informal, and agricultural versus non-agricultural sector workers. Data from the Kenya Integrated Household Budget Surveys 2005/2006 and 2015/2016 are used in the analysis. Data from these surveys were used to categorize workers and extract the price values for commodities. One hundred and twenty-one commodities classified as agricultural or manufactured goods are analyzed. Much of the reduction in import tariffs and hence reduction in commodity prices is on manufactured goods. A Mincerian wage equation that is corrected for survey design and heteroskedasticity is estimated. Further, a sensitivity analysis using a Poisson Pseudo Maximum Likelihood model is estimated. The price-labor income effect is observed to vary with the classification of workers in the country. Skilled, formal, and non-agricultural workers gained compared to their counterparts. Workers in counties that border the EAC countries and those in the major cities in the country gained more than other workers in other counties in the country. However, in all parts where gains are experienced, the magnitude is small. This shows that generally, the Common External Tariff did not have a very significant effect on labor incomes in Kenya.

CONSUMER EXPENDITURE OF RURAL HOUSEHOLDS IN POLAND

The main target of the research was to diagnose the level and structure of consumption expenditures of rural households in Poland in 2015-2021. Among consumption expenditures, special attention was paid to fixed expenditures, i.e. on food and non-alcoholic beverages, as well as on housing and energy carriers. Expenditures of rural households were compared to expenditures of urban households and analyzed against the background of all households in Poland. The data source was individual, unidentifiable data from the “Household Budget Survey” conducted by the Central Statistical Office in 2015-2021. It was noticed that in the years 2015-2021, relatively large disproportions in the level of consumption expenditure between rural and urban households were observed. In 2015, consumption expenditures per capita in households living in rural areas accounted for less than 3/4 of expenditures of households living in urban areas. However, in the analyzed period, the increase in the level of this occurrence was more than twice as high for rural households, which proves a pronounced convergence process. The greatest burden on rural household budgets was expenditure on food and non-alcoholic beverages, which in rural households amounted to about 30%, and in 2020, i.e. the first year of the Covid-19 pandemic, it exceeded 32%. It was noticed that the structure of consumption expenditures between rural and urban households were very similar in 2015 and 2021.

Seasonal and Regional Differences in Eating Times in a Representative Sample of the Brazilian Population.

Human food intake and its timing are a complex behavior that can be influenced by a variety of factors, some of which may vary from season to season or from region to region. In this study, our aim was to investigate the seasonal variation in food intake times, with a particular focus on how these may vary across different regions of a country. We conducted an analysis of data from 20,622 adults from the National Household Budget Survey (POF-IBGE), encompassing complete food diaries collected from individuals residing in Brazil, and thereby ensuring representation across different latitudes. Each participant's daily food intake was reported for two non-consecutive days at different times in the same week using food diaries. An ANOVA revealed a later food intake time in the evening in high-latitude regions compared to low-latitude regions. The Sidak post-hoc test showed a significant interaction effect between region and season, demonstrating a pattern of early First Intake Time and Eating Midpoint in the Northeast region during spring/summer. Additionally, we observed an independent effect of the region, as early food intake times were found in low-latitude regions. These findings offer a basis for discussing food intake times among individuals living in different regions located on distinct latitudes.

Pass-Through Effects of the East African Community Common External Tariffs on Kenya's Domestic Prices

This study offers an empirical microlevel analysis of the pass-through effects of the East African Community Common External Tariff on consumer prices in Kenya. Using data from the Kenya Integrated Household Budget Surveys conducted in 2005 and 2015, this research employs a fixed-effects model to estimate pass-through equations. The analysis focuses on consumer prices for agricultural and manufactured goods. It also considers household residential classifications, distinguishing between rural and urban areas, and it investigates the impact of border proximity and transportation costs on the pass-through effect. The findings show that manufactured goods have a significant pass-through effect. A 1% change in tariffs results in a 0.84% change in consumer prices for manufactured goods. However, the pass-through effects for agricultural goods were incomplete, suggesting that markets for manufactured goods are more competitive in Kenya. The study also found that pass-through effects vary depending on proximity to borders and the urban-rural divide.

Assessing the Level of Consumption by Children in Households

In the context of changing the demographic structure of the population (population aging) in order to determine the demand for goods and services and predict key socio-economic indexes, consumption age indexes are of practical interest for research. A feature of collecting information on the level of consumption is the conduct of surveys for the household as a whole, and not for a specific member of the household. At the same time, it should be noted that throughout the life cycle of a person, the level and structure of consumption differ. Methods for assessing the level of consumption in households of different generations are of greatest interest on the part of researchers. Current trends in developing and developed countries are characterized by a move away from multi-generational living. Thus, estimates of the level of consumption by children in households with parents are of practical interest.The purpose of the study. At present, there are no unequivocal recommendations on how to estimate the calculation of children’s consumption in households. At the same time, the available methods have been subjected to various criticisms from economists. It should be noted that most of the research on this topic was carried out at the end of the 20th century. At the same time, it is necessary to take into account possible cross-country features of consumption financing: the availability and development of medicine and education. If social services are available and provided at the expense of the state in a country, then the level of consumption by children will be lower. If the household finances the social sphere, the level of consumption by children in households will be higher. Thus, it is of practical interest to assess the level of consumption by children in Russian households.Materials and methods. Based on data from the Household Budget Survey (HBS) for 2020 conducted by Rosstat, households consisting of two adults and two adults with one child are selected. With the help of classical methods of statistical analysis, the construction of age profiles of consumption for each group of households is carried out. Based on the share of expenditures on food in the household and the scale effect of their consumption, the paper constructs age estimates for the redistribution of the level of consumption depending on the age of children. In addition, the sample size allows us to test the hypothesis about the age of birth of the child and the level of consumption.Results. The study made it possible to assess the differences in the level of consumption by children depending on the age at which a child was born. The average age of a child’s birth determines his/her further level of consumption throughout adulthood. Consumption is lowest among children who are born when parents are less than 26 years old. The obtained redistribution coefficients for ages under 15 are higher than in the estimates proposed by R. Lee, E. Mason, and Deaton, that confirms the possible consumption patterns of Russian households.Conclusion. This article draws two key conclusions. The age at which a child is born determines his/her level of future consumption: the birth of a child under the age of 24 indicates a relatively low level of consumption throughout their adulthood. The estimates obtained for the level of consumption by children depending on their age indicate higher consumption up to 14 years of age than in foreign methods that can be explained by the socio-economic characteristics of Russian households.

The impact of health insurance enrollment on health outcomes in Kenya

BackgroundThe achievement of the global agenda on universal health coverage (UHC) is pivotal in ensuring healthy lives and promoting the well-being of all. However, achieving healthy lives and wellbeing of all has been hampered by the challenge of health care financing. As such, healthcare financing, through health insurance is gaining popularity in developing countries such as Kenya, in their pursuit to achieve universal health coverage. The primary purpose of health insurance and delivery is to improve health. However, there is a paucity of evidence on the effectiveness of health insurance in improving the health outcomes and health status of the Kenyan population. Therefore, this study aimed to analyze the impact of health insurance on health outcomes in Kenya.MethodsThe study utilized the most recent nationally representative Kenya Integrated Household Budget Survey (KIHBS) 2015/16 dataset in order to analyze the impact of health insurance on health outcomes. The instrumental variable 2-stage least squares (IV 2SLS) and control function approach (CFA) estimation techniques were used to cater for potential endogeneity and heterogeneity biases present in ordinary least squares (OLS) estimators.ResultsHealth insurance enrolment leads to a reduction in mortality, thereby improving the health status of the Kenyan population, despite low levels of insurance uptake. However, the insured population experienced higher chronic illnesses and out-of-pocket (OOP) expenditures raising concerns about financial risk protection. The fact that health insurance is linked to chronic illnesses not only reinforces the reverse causality of health insurance and health status, but also that the effects of potential adverse selection strongly drive the strength and direction of this impact.ConclusionsWe conclude that health insurance enrolment reduces mortality and hence has a beneficial impact in promoting health. Health insurance coverage therefore, should be promoted through the restructuring of the National Hospital Insurance Fund (NHIF) fragmented schemes and by consolidating the different insurance schemes to serve different population groups more effectively and equitably. The government should revisit the implementation of a universal social health insurance scheme, as a necessary step towards UHC, while continuing to offer subsidies in the form of health insurance to the marginalized, vulnerable and poor populations.