In August 2013 researchers, practitioners and policymakers gathered in Kigali, Rwanda to discuss and debate one of the biggest challenges to achieving Universal Health Coverage – how to extend financial protection and equitable access to health services to those outside the formal employment sector. 

The three-day workshop brought together representatives from six countries in Africa and Asia to share country experiences of extending health coverage to the informal sector. Held in Rwanda, the only country that has managed to achieve high levels of coverage through community-based health insurance schemes, the workshop focused on the merits and disadvantages of different financing approaches.

This report aims to capture a record of the workshop including profiles of participating countries and their efforts to extend coverage to the informal sector. It gives an overview of the central themes that were discussed during the workshop and summarises an organised debate on tax versus insurance-based financing approaches. Finally, it presents the key conclusions from the discussions.