Objectives To describe the range of strategies for expanding health insurance coverage for vulnerable population and how the authors have assessed these strategies. Methods Search words were chosen by both health policy experts and search coordinators after discussion and pilot. What was searched included 28 electronic databases, 12 websites of health institutions, 3 grey literature databases and search engine Google. Any report of implemented strategies to expand health insurance coverage for vulnerable population was included. Pre-designed data extraction form was used for collecting strategies and study methods of the included studies. Then the extracted information was analyzed and described. Results A total of 86 studies were included, most of which were the ones in the U.S. and the main targeted population was children. In terms of the study objective, 61 studies aimed to describe strategies and 25 ones are to evaluate effectiveness of the strategies. All strategies could be categorized into 6 groups based on the theoretical framework: changing eligibility criteria of health insurance, increasing awareness, making premium affordable, innovating enrollment approaches, improving health care delivery and strengthening management capacity. Most of the studies evaluating effectiveness were retrospective analysis of longitude data, and there were also two experimental studies. Conclusions The U.S. and other developed countries have implemented a great many strategies for expanding insurance coverage, while few strategies and related studies are found in developing countries. However, developing countries can learn from the developed countries in extending health insurance coverage. The 25 included studies evaluating strategies need further systematic reviews to assess the effectiveness of these strategies.
目的：调查了解成都市建筑工地工作的流动人口工人的生殖健康现状，为项目的干预打下基础。方法：采用定量调查和定性研究相结合的方法获取相关数据和信息。结果和结论：流动人口中的建筑工人的确是一个获取生殖健康知识和服务方面十分脆弱的人群：1)流动人群中的建筑工人们的健康状况不容乐观。他们大都看似健康，但健康知识贫乏、不重视自身生殖健康、寻求健康服务的行为单一且不安全；2)建筑公司和工地基本不允许女工在工期怀孕；除特殊工种外，工人没有体检；一般只给工人买工伤险，但没有医疗保险；3)流动人群中的建筑工人们对性与生殖健康方面的需求是迫切的。但他们求医难，寻求性与生殖健康服务更难。