These include older women, women living in remote areas, as well as women and men from ethnic minority and migrant communities. Membership is voluntary and, in most cases, CBHI schemes are run on a nonprofit and participatory basis. In the United Republic of Tanzania, for example, it took social and community-based insurance schemes a decade to enrol only 17 per cent of the population.179 In Ghana, where community-based plans were absorbed into the National Health Insurance Scheme (NHIS) from 2003 onwards, almost two thirds of the population remained without coverage in 2011.' Mutuelles de Sante were piloted in three districts in 1999 and later extended to other districts.