The creation of non-contributory programmes alongside contributory ones allows for an increase in social protection coverage, notably for health. However, such non-contributory programmes should be designed so as to minimise the disincentives that may arise to work formally. This can be done by enforcing means-tested fees with a subsidy element which decreases as income rises, thus allowing a smooth transition towards the contributory programme. An alternative would be to switch to a universal tax-financed health system, as was done in Brazil.