Health Insurance in Algeria: Current Challenges and Future Directions Towards Universal Health Coverage

Abstract

Algeria faces major challenges in modernizing its health insurance system to achieve Universal Health Coverage (UHC). This research examines the trajectory of Algeria’s health insurance system toward Universal Health Coverage (UHC) by analyzing its current structural, financial, and organizational challenges, while proposing evidence-based strategic orientations for reform. Employing a mixed-methods design that integrates secondary quantitative data with qualitative stakeholder analysis and international benchmarking, the study reveals that despite notable progress in formal enrollment, significant gaps persist in coverage of vulnerable populations, inter-agency coordination between CNAS and CASNOS, and long-term financial sustainability. Data show that the revenue to expenditure ratio, currently 1.02, risks declining to 0.87 by 2030 under a business-as-usual scenario. The findings indicate that a successful transition to UHC requires integrated structural reform, innovative and diversified financing mechanisms, and accelerated digitization of administrative systems. Incorporating lessons from post COVID 19 health financing shocks, this research contributes to the academic literature on health systems in North Africa and offers a replicable conceptual framework applicable to middle-income developing nations.