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A frequently used indicator to measure social health protection performance is the extent of population coverage as stipulated in national legislation. However, this indicator does not provide meaningful information on performance in terms of effective access to benefits that are available, affordable and of acceptable quality, not least for the poor and workers in informal economies. This article proposes a new approach to measuring performance by applying a set of relevant indicators in an analytical framework for assessing the performance of social health protection. The approach allows policy-makers to conclude from comparisons among groups of countries facing similar challenges. Preliminary results include comprehensive information on deficits that need to be addressed when striving for effective universal coverage. With further refinement, the suggested approach could become a standard assessment tool for measuring performance.i ssr_1400 21..38

To counter the negative social consequences of the present crisis, States must take measures to provide income support and new employment opportunities to affected workers and their families. This article reviews crisis responses in a number of countries with respect to support from unemployment programmes, the branch of social security most directly affected by economic downturn. It also discusses the trade offs that all social security schemes face during economic crises, when revenues from contributions or taxes earmarked to finance programmes fall and expenditures on benefits rise. In turn, concerns about pension policies receive special attention. The article concludes by discussing the initiative, launched by the United Nations, for a global "social protection floor": to extend, at the very least, basic social protection to the large majority of the world's population who are currently without and who remain vulnerable to all economic and social risks.i ssr_1361 47..70

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Résumé Un indicateur fréquemment utilisé pour mesurer la performance de la protection sociale de la santé est l'étendue de la couverture de la population, comme le prescrit la législation nationale. Or, cet indicateur ne fournit pas de réelles informations sur la performance en termes d'accès effectif à des prestations qui sont accessibles matériellement, financièrement et de qualité acceptable, surtout pour les pauvres et les travailleurs des économies informelles. Cet article propose une nouvelle méthode d'évaluation de la performance qui a recours à une série d'indicateurs pertinents qui s'inscrivent dans un cadre analytique d'évaluation de la performance de la protection sociale de la santé. Cette méthode permet aux décideurs politiques de dégager des conclusions à partir de comparaisons établies entre des groupes de pays qui sont confrontés à des enjeux similaires. Les résultats préliminaires comportent des informations détaillées sur les déficits auxquels il faut remédier lorsqu'on s'emploie à instaurer une couverture universelle effective. Cette méthode, quelque peu peaufinée, pourrait devenir un instrument type pour évaluer la performance.