Learning across borders: How global exchange is helping shape Egypt’s Universal Health Insurance reform
This summer, the Egypt Impact Lab (EIL) launched a needs assessment that could lead to one of the first randomized evaluations of informal workers’ inclusion in a national health insurance system in Egypt. But the starting point was not a research protocol or technical workshop, it was a series of conversations.
Policy conversations often happen far from where decisions are actually made. And even when lessons learned and evidence is shared in policy spaces, it rarely comes with a clear path to action. Through EIL, we wanted to explore a different model: using cross-country exchange to support a live government reform process. Working with the Universal Health Insurance Authority (UHIA) and the World Health Organization (WHO) in Egypt, and drawing on experiences and connections across the J-PAL network, we designed a series of exchanges with policymakers intended not only to inform, but also to contribute to decision-making.
Policy dialogue as a tool for partnership-building
In collaboration with UHIA and WHO Egypt, EIL launched the Knowledge Exchange Webinar Series to connect Egyptian policymakers with governments that had tackled similar health reform challenges, helping inform key policy decisions as Egypt continues the rollout of its Universal Health Insurance System (UHIS).
Designed as a government-to-government exchange, the series brought together policymakers, implementers, researchers, and technical experts across countries to engage in practical discussions grounded in real policy challenges. Rather than treating knowledge exchange as a standalone activity, the series was embedded within an ongoing collaboration with UHIA, creating continuity between dialogue, policy thinking, and implementation.
A journey across countries: Matching global experience to local questions
Egypt’s UHIS is a relatively new reform. Since its rollout in 2019, policymakers have focused increasingly on how to improve the program’s sustainability and benefit package design, as well as how to expand enrollment among informal workers.
However, these challenges are not unique to Egypt. Countries such as Chile, Thailand, and Indonesia have spent decades expanding universal health coverage while managing complex implementation tradeoffs. EIL’s webinar series aimed to draw lessons from these other country contexts to respond to the challenges emerging in Egypt’s reform process.
Over three sessions in 2025, the series brought together Chilean, Thai and Indonesian health officials, researchers, and health financing experts to address the core questions facing Egypt's Universal Health Insurance System (UHIS): What does it take for a country to commit to universal health coverage? How should governments decide what to cover under a national health insurance scheme? And how can they expand coverage to informal sector workers? In partnership with J-PAL Latin America and the Caribbean, the first session explored Chile's political path to universal health coverage. The second session, organized with J-PAL Southeast Asia, examined Thailand's evidence-based approach to designing and updating national health benefit packages. The third session focused on Indonesia's strategies for enrolling informal workers—a challenge that closely aligns with EIL's ongoing collaboration with Egypt's Universal Health Insurance Authority (UHIA). By bringing together evidence from a randomized evaluation alongside government implementation experience, the discussion helped refine the research questions for EIL and UHIA's needs assessment on informal workers' inclusion, laying the groundwork for a potential impact evaluation.
Behind the scenes, this series required coordination across J-PAL offices to identify which country experiences most directly matched Egypt’s evolving priorities, connect with speakers who had lived through similar reforms, and shape each session around Egypt’s policy questions, rather than around generic lessons learned.
For governments navigating complex reforms, this kind of exchange matters because reform design rarely happens in vacuum. Through the Knowledge Exchange Webinar Series, EIL not only convened discussions, but acted as a bridge between Egyptian policymakers and relevant international experiences, curating lessons learned, facilitating peer connections, and creating a space where global evidence could directly inform national decision-making.
From dialogue to design: Turning exchange into action
Around the same time that EIL launched the webinar series, Egypt's government began planning a needs assessment to explore a key question: what barriers prevent informal workers from regularly paying UHIS premiums, and which interventions can address them? While EIL and UHIA were already exploring this policy question, the third webinar created an opportunity to bring in evidence from Indonesia, including findings from a previous randomized evaluation, and reflections from researchers and implementers who had worked directly on similar questions. These exchanges helped sharpen Egypt’s evaluation design and connect international evidence to local realities.
The series also helped deepen engagement with development partners already supporting UHIS implementation. Through the webinars, partners experience first-hand how EIL works as a technical and research partner embedded within government reform processes. This engagement also helped secure funding from Agence Française de Développement (AFD) for Egypt’s needs assessment, showing that connecting policy conversations to concrete research can unlock new support.
Looking ahead: Cross-office collaboration as a model for reform support
This experience suggests that policy dialogue can play a different role than we often expect. When grounded in government priorities, connected to implementation decisions, and supported by collaboration across teams and regions, it can become more than a space for learning, it can become part of the reform process itself.
What started as a series of conversations became a way to connect global experience with local decision-making—and ultimately helped create momentum toward research, implementation, and action.
Explore the webinar recordings and more key takeaways from the series.