A joint ILO and UNHCR feasibility study assessed the inclusion of refugees and asylum-seekers in the national Universal Health Insurance scheme, identifying a legal framework and proposing cost policy options. Five policy papers explored the legal, institutional and financing pathways. This work supported the government to design a pilot two governorates. PROSPECTS  supported the government on universal health insurance by initiating  a survey and  study to  inform recommendations. The universal health insurance authority (UHIA) endorsed the study and requested support to developed a strategy for coverage of informal workers. 

PROSPECTS programme teams supported the review of national social protection strategies and advocated for the inclusion of refugees and non-nationals. A joint ILO and UNHCR study assessed the feasibility of enrolling urban refugees and asylum-seekers in the Community-based Health Insurance (CBHI) scheme in Addis Ababa. In collaboration with the Ababa Health Bureau and RRS, the program enrolled approximately 40,000 households in the national health insurance scheme. 

PROSPECTS designed a targeted scheme for the extension of social security to informal workers, including refugees. The scheme, called the Estidama++ programme, introduced a contribution subsidy model and targeted outreach, successfully registering thousands of non-nationals in social security. Project data showed a relatively high retention rate among workers that received subsidies on social security contributions, with 81.2% of Syrian self-employed workers continuing to make contributions as the subsidy was phased out. There was considerable investment in outreach to and raising the awareness of the Social Security Corporation on the protection needs and realities of refugees in the country. In-person visits produced a 14% increase in enrolment in social security compared to when information was communicated via SMS. ILO, the World Bank and the Jordanian Social Security Corporation launched a study on extending social insurance with recommendations made on regulatory updates, flexible contribution modalities, and simplified administrative processes.

Kenya incorporated refugees under a  Social Health Insurance Law, passed in 2023. PROSPECTS supported several national social protection schemes and strategies to ensure refugee inclusion was given practical effect by law. In collaborated with Kenya's National Social Protection secretariat to draft the National Strategy for Extension of Social Protection Coverage to Workers in the Informal and Rural Economy. Kenya also incorporated refugees under its  Social Health Insurance Law, passed in 2023. The programme supported the integration of refugees into the Enhanced Single Registry (ESR), a centralized database used for cash transfers and other benefits, and conducted costing exercises for maternity and health schemes. At the county level, PROSPECTS supported consultations and provided technical guidance in the drafting and approval of the Garissa County Social Protection Policy. 

In Lebanon, farmers and agricultural workers are not covered by the Labour Code and the National Social Security Fund, leaving them without access to social protection. Since 2023, under the PROSPECTS programme, the ILO has been conducting interviews and discussions throughout the country to understand social protection challenges faced by farmers and agriculture workers. These informed pilot that used integrated pathways to extend social health protection as part of the formalization of agriculture workers. The pilot helped assess the legal, financial and administrative feasibility of such models and established linkages between social protection and work permit processes. 

In addition, the ILO and UNICEF  collaborated with the Ministry of Social Affairs to design and operationalize an inclusive, rights-based National Disability Allowance. The NDA reflects a shift toward a more inclusive and lifecycle-based national social protection system and serves as a building block for the 2024 National Social Protection Strategy. The overall approach was inclusive across communities, not just for Lebanese PWDs, providing an entry point for the extension of the National Disability Allowance (NDA) to refugee PWDs.

PROSPECTS programme teams supported the review of national social protection strategies. They also actively advocated for the inclusion of refugees and non-nationals on a par with nationals within these strategies. Inclusion studies of national health insurance schemes were conducted and fed into dialogue with social protection policymakers.

In Uganda the National Strategy on Extending Social Protection Coverage to All Workers, developed by the Ministry of Gender, Labour and Social Development (MGLSD), focuses on the situation of workers with informal working relationships. It further references the need for strengthening formalization of micro-small and medium sized enterprises. The ILO’s Social Security Inquiry tool was used to gather data on national social protection coverage levels and gaps for both nationals, migrant workers and refugees. Consultations with social partners and line ministries on the draft strategy pointed to a need to better align the strategy with international standards, namely ILO Convention 102 (Minimum Standards) and Recommendation 202.  An accompanying costing framework highlighted strategic priority areas and funding implication for implementing the Strategy on extending social protection to all workers.  Under the PROSPECTS programme, ILO and UNHCR also worked with the National Social Security Fund (NSSF) to extend the NSSF’s savings scheme to host communities and FDPs.