Social Health Insurance (SHI) is crucial in enhancing healthcare accessibility, ensuring financial security, and improving health outcomes in developing nations. This review examines the development, influence, and challenges of SHI systems in developing countries. The National Health Insurance Scheme in Ghana and the Universal Coverage Scheme in Thailand exemplify the advantages of extensive coverage and inventive finance. Nigeria’s National Health Insurance Scheme is encountering difficulties in expanding its coverage to include the informal and rural sectors. SHI programs have effectively decreased the incidence of illness and death, enhanced the consumption of healthcare services, and lessened the financial burden on individuals. Nevertheless, problems such as discrepancies in coverage, the ability to maintain financial stability, and fair and equal access continue to exist. To address these issues, it is necessary to enhance governance, raise public knowledge, invest in healthcare infrastructure, and adopt culturally sensitive approaches. Regular monitoring and assessment are necessary to optimize SHI systems for achieving universal health coverage and ensuring fair access.