Economic impact of pro-SME policies
14 Can productivity in SMEs be increased by investing in workers’ health?
excludes workers in the informal economy. Some countries such as Kenya have attempted to avoid this issue by offering informal workers access to the scheme through flat rates
Joint Learning Network, 2013.
Social health insurance schemes often feature waiting periods between the beginning of contributions and access to medical care, for example in the United Republic of
Tanzania where a waiting period of three months is mandated Tanzania, NHIF website, 2012. No empirical data could be found on whether this waiting period influences fraud
and abuse. It is conceivable that any adverse health-related event occurring during this period could be magnified by the financial strain of already paying contributions.
Coverage
The provision of social protectionsocial security for workers varies considerably between countries in both extent and structure. The legal framework for coverage of
workers in the formal economy is often advanced, given the existence of a legislative basis for coverage of formal economy employees in SMEs in every country that was evaluated.
According to the ILO World Social Security Report 201011 ILO, 2011a there is no country that does not offer at least some form of social security.
In the course of our research, no publications were found that would indicate that the number of employees is a key determinant for social protection coverage or access. With
regard to occupational health and safety regulation, most countries make no distinction between enterprises on the basis of the number of employees. In Canada, for example, the
same labour safety regulations apply to all workers Champoux and Brun, 2003.
In considering social health insurance in particular, one important question regards the order in which social groups are admitted to the scheme. Presumably due to the high
degree of formalization and the associated ease of collecting contributions from government and public sector employees, most social health insurance schemes have
started out for these groups and have been extended to other sectors at later points in time. Health-care coverage for SME workers depends on how far this development and their
inclusion has already progressed Carrin and James, 2005.
Generally, we find a significant lack of coverage for the informal economy; informal workers are often those who do not participate in the schemes. How far this represents
active exclusion from coverage is questionable, as employment in the informal economy is usually not desired by lawmakers but rather a result of employer andor employee
decisions.
For SME workers in many countries, the most significant deciding factor for coverage by health and other social protection schemes and systems often relates to the question
whether the employment takes place in the formal or the informal economy. For the individual worker, other than the degree of formality, wealth and income seem to be
amongst the most significant factors for an entitlement to coverage, as many programmes are targeted specifically to the poor. In India for instance, workers are eligible for social
security benefits only up to a certain wage threshold, while there are special schemes for individuals living below the poverty line Dutta and Hongoro, 2013; LawsIndia, 2001.
In many countries there is a strong discrepancy between the number of people who should be statutorily covered by social protection schemes compared to the number who
actually have access to them. Kenya, Nigeria and United Republic of Tanzania, for example, all have health insurance schemes that statutorily cover the majority of their
populations, but only effective coverage rates of 15, 3 and 7 per cent respectively have been achieved Scheil-Adlung et al., 2006; Dutta and Hongoro, 2013; Tanzania, NHIF
website, 2013.
Can productivity in SMEs be increased by investing in workers’ health? 15
Social security benefits such as retirement pensions, disability pensions and funeral grants are usually provided separately from health-care provision. Health care may either
be provided through tax-financed schemes for the entire population, or alternatively via a social or national health insurance scheme for those who register as members. In the latter
case, special arrangements need to be put in place to cover those working in the informal economy.
The provision of health care is sometimes managed together with that of most other social security benefits, as is the case in India. The provision of services such as disability
pensions and paid sick leave together with traditional health care will allow for more comprehensive social protection, as individuals will be shielded from multiple dimensions
of adverse health states. Workers will not only receive appropriate medical treatments, but will also be assured of an income while unable to work. Individuals who are not part of the
scheme, however, would frequently suffer from multiple dimensions of adverse health- related states. No studies have been found that evaluate whether one comprehensive social
security scheme results in more effective coverage than multiple individual schemes for the different aspects of social security. A system in which the different benefits are applied
by a variety of schemes could have a higher likelihood of any given individual having access to at least some type of social protection.