Abstract
Background: Extending social insurance to informal employment has become a goal among international and national authorities. For Thailand, the voluntary social security scheme under Article 40 (A40) of the Social Security Act covers only seventeen percent of the total informal workers of 20.4 million. Many studies had identified factors relevant to the enrolment and renewal of voluntary social health insurance scheme. Thailand can learn and use the existing research findings from international perspectives to improve the coverage of voluntary social security scheme continuously and efficiently. Methodology: Searches of electronic databases from Google Scholar, PubMed, ThaiJo and ThaiLis were conducted. Studies that aimed to identify factors associated to the enrolment and renewal of health or social insurance, A40, and the National Saving Fund (NSF), written in English and Thai were included for the analysis. Key results: Ten studies were included in this review. The included studies reported demographic factors, education, occupation, income, knowledge and understanding of the scheme, quality of services, health issues, benefit package adequacy, and socio-cultural factors as significant determinants of the enrolment in a voluntary health insurance scheme, the A40, and the NSF. Conclusion: The present study provides evidence on determinants of the enrolment in a voluntary health or social insurance scheme that applicable to the Article 40 of Thai Social Security Act. Strategies should be developed with consideration of those significant determinants to increase the coverage and sustainability of the scheme.
