Table 5. Summary of results based on type of insurance, only 18 studies with high quality and low risk of bias.

Country and type of insurance scheme	Summary
Community-based health insurance/CBHI (N = 5 studies)	Overall: positive effect on utilisation but two studies from India shows no positive effect. Positive effect on financial protection but not in India. Contentious effect on health status
1. Burkina Faso	Positive effect on utilisation [38], reduced catastrophic health expenditure events, but negative effect on elderly’s health, ≥ 65 years old.[75] No effect among adults < 65 years old and children.[75]
2. Cambodia	Positive effect on utilisation, reduced OOP health expenditure, but no effect on health status [39]
3. India	Reduced consumption of health care but the author argued it could be that the enrolees were becoming healthier reducing their need to seek care.[37] Another paper shows no effect on utilisation and OOP health expenditure [36]
Voluntary health insurance, non-CBHI (N = 7 studies)	Overall: positive effect on utilisation. Inconclusive on financial protection, but there is an indication it is affected by rurality and proximity to adequately-staffed health facilities. Positive effect on specific health status, but not mortality rate.
1. Ghana	Positive effect on utilisation [54]
2. Vietnam	Positive effect on utilisation but no effect on OOP health expenditure [69]
3. Mexico	Reduced health expenditure among enrolees living in rural area and proximate to large health facilities. Similar effect among the enrolees living in urban area [76]
4. Philippines	Positive effect on health status measured by wasting and C-reactive protein level [103]
5. China	Positive effect on utilisation among the elderly enrolees (>65 years old) [45]; no effect on OOP health expenditure [45] but reduced non-medical consumption among the enrolees[79]; No effect on mortality rate [45,98]
Compulsory health insurance, non-CBHI (N = 6 studies)	Overall: positive effect on utilisation. Inconclusive evidence on financial protection, positive effect on specific health status.
1. India	Reduced OOP health expenditure for inpatient care [77]
2. Vietnam	Positive effect on utilisation but not on OOP health expenditure [73]
3. Georgia	Positive effect on utilisation [50]
4. Peru	Positive effect on utilisation of preventive and curative care, but negative effect on OOP health expenditure [62]
5. Colombia	Positive effect on utilisation and reduced OOP health expenditure [49]Positive effect on newborn health measured by incidence of low birth weight and several indicators of preterm baby [89]