Table 2 Outcome indicators, definitions, measures and examples of data synthesis

Enrolment

Actual scheme enrolment, retention or dropout of health insurance measured by rates.

Higher enrolment rates were graded as having a positive effect compared to the general population, since it is assumed to improve access to health services and reduced outlays for health care. If enrolment was higher compared to general population but the difference was not statistically significant (i.e. p > 0.05), this was categorized as a positive effect without statistical significance (noted as +^).

Utilization of healthcare services

Defined as utilization of specific healthcare services by the particular populations. Measures include (probability of) visits to health care providers in general during a specified period prior to survey across members and non-members (one year, 6 months), and use of in-patient care or out-patient care or a comparison between those. Utilization was either expressed as percentages or as probability to make use of health care (odd ratios).

Higher probability to receive hypertension treatment, compared to non-member, showed a positive effect (+), equal use of primary care service for last 6 months compared to other groups/general population had no effect (0), for female headed households less outpatient and inpatient visits compared to male headed households showed a negative effect (−)

Financial protection

Defined as protection against catastrophic health expenditures; measured by out-of-pocket expenditures for health care, in absolute terms or expressed as a proportion of total income or total medical expenditure, or measures related to catastrophic health expenditures (absolute or relative) and the net benefits (financial reimbursement) received by scheme members.

Lower catastrophic health expenditures showed a positive effect for the particular group (+), more use of savings or borrowed money for one type of insurance compared to other types was reported as negative effect (−), no effect of a scheme on reducing enrollees’ total medical expenditure was reported as (0).

Health outcomes

Defined as relevant health outcomes for the vulnerable group, e.g. mortality rates, self-assessed general health status, functional limitations.

Reduced mortality rates among people with chronic illnesses was reported as a positive effect.

Quality of care

Defined as the performance of health services in terms quality of health care, e.g. services covered, efficiency of services or trust.

Improved access to medicine was reported as a positive effect (+), low confidence in scheme by the particular group showed a negative effect (−)