IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v61y2005i7p1430-1438.html
   My bibliography  Save this article

Trust in micro-health insurance: an exploratory study in Rwanda

Author

Listed:
  • Schneider, Pia

Abstract

Micro-health insurance (MHI) has been proposed as an alternative to user fees to improve access to medical care without the threat of financial impoverishment. To enrol in health insurance and pay a premium, consumers should be able to trust that insurers use their funds to reimburse providers who will deliver quality care when needed. In 1998, shortly after the re-introduction of user fees, the Rwandan Ministry of Health in close collaboration with the local population developed and implemented MHI in three districts. Member benefits cover preventive and curative care in health centres and ambulance transport to the district hospital where a limited package of services is also covered by MHI. This paper examines trust-building structures and practices in MHI in Rwanda. It is an exploratory, descriptive analysis using information collected from focus groups. Findings suggest that MHI managers, providers and policy-makers need to think systematically about a wide range of initiatives that enhance trust and caring, and to design trust-building structures and practices in the consumer-insurance-provider arrangement.

Suggested Citation

  • Schneider, Pia, 2005. "Trust in micro-health insurance: an exploratory study in Rwanda," Social Science & Medicine, Elsevier, vol. 61(7), pages 1430-1438, October.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1430-1438
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(04)00665-3
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Besley, Timothy & Coate, Stephen & Loury, Glenn, 1993. "The Economics of Rotating Savings and Credit Associations," American Economic Review, American Economic Association, vol. 83(4), pages 792-810, September.
    2. Besley, Timothy, 1995. "Savings, credit and insurance," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 36, pages 2123-2207, Elsevier.
    3. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    4. Coleman, James S, 1984. "Introducing Social Structure into Economic Analysis," American Economic Review, American Economic Association, vol. 74(2), pages 84-88, May.
    5. Ahern, Melissa M. & Hendryx, Michael S., 2003. "Social capital and trust in providers," Social Science & Medicine, Elsevier, vol. 57(7), pages 1195-1203, October.
    6. Jonathan Morduch, 1995. "Income Smoothing and Consumption Smoothing," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 103-114, Summer.
    7. Mr. Francis Fukuyama, 2000. "Social Capital and Civil Society," IMF Working Papers 2000/074, International Monetary Fund.
    8. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    9. Criel, Bart & Waelkens, Maria Pia, 2003. "Declining subscriptions to the Maliando Mutual Health Organisation in Guinea-Conakry (West Africa): what is going wrong?," Social Science & Medicine, Elsevier, vol. 57(7), pages 1205-1219, October.
    10. Randall P. Ellis & Thomas G. McGuire, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-151, Fall.
    11. Straten, G. F. M. & Friele, R. D. & Groenewegen, P. P., 2002. "Public trust in Dutch health care," Social Science & Medicine, Elsevier, vol. 55(2), pages 227-234, July.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. David Mark Dror, 2018. "What Factors Affect Voluntary Uptake of Community-based Health Insurance Schemes in Lowand Middle-Income Countries? A Systematic Review and Meta-Analysis," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 14, pages 271-306, World Scientific Publishing Co. Pte. Ltd..
    2. Clara Delavallade, 2014. "Quality Healthcare and Health Insurance Retention: Evidence from a Randomized Experiment in the Kolkata Slums," Working Papers id:5916, eSocialSciences.
    3. Thomas Rouyard & Yukichi Mano & Bocar Mamadou Daff & Serigne Diouf & Khadidiatou Fall Dia & Laetitia Duval & Josselin Thuilliez & Ryota Nakamura, 2022. "Operational and Structural Factors Influencing Enrolment in Community-Based Health Insurance Schemes: An Observational Study Using 12 Waves of Nationwide Panel Data from Senegal," Post-Print halshs-03641124, HAL.
    4. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2019. "Can information increase the understanding and uptake of insurance? Lessons from a randomized experiment in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 220(C), pages 102-111.
    5. Francisco Galarza & Ingo Outes Leonb, 2016. "Do you want some cash-back? Assessing the demand for a no-claim rebate life-insurance product," Working Papers 16-04, Centro de Investigación, Universidad del Pacífico.
    6. Ridde, Valery & Haddad, Slim & Yacoubou, Moussa & Yacoubou, Ismaelou, 2010. "Exploratory study of the impacts of Mutual Health Organizations on social dynamics in Benin," Social Science & Medicine, Elsevier, vol. 71(3), pages 467-474, August.
    7. Saksena, Priyanka & Antunes, Adélio Fernandes & Xu, Ke & Musango, Laurent & Carrin, Guy, 2011. "Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection," Health Policy, Elsevier, vol. 99(3), pages 203-209, March.
    8. Osei Afriyie, Doris & Masiye, Felix & Tediosi, Fabrizio & Fink, Günther, 2023. "Confidence in the health system and health insurance enrollment among the informal sector population in Lusaka, Zambia," Social Science & Medicine, Elsevier, vol. 321(C).
    9. Lin, Wanchuan & Liu, Yiming & Meng, Juanjuan, 2014. "The crowding-out effect of formal insurance on informal risk sharing: An experimental study," Games and Economic Behavior, Elsevier, vol. 86(C), pages 184-211.
    10. Mladovsky, Philipa, 2014. "Why do people drop out of community-based health insurance? Findings from an exploratory household survey in Senegal," Social Science & Medicine, Elsevier, vol. 107(C), pages 78-88.
    11. Juliette Alenda-Demoutiez & Bruno Boidin, 2019. "Community-based mutual health organisations in Senegal: a specific form of social and solidarity economy?," Post-Print hal-02400072, HAL.
    12. Petro G. Nzowa & Felix A. Nandonde & Somo M. L. Seimu, 2023. "Mediation effect of trust on willingness to pay for health insurance among co-operative members in Tanzania," Future Business Journal, Springer, vol. 9(1), pages 1-15, December.
    13. Arun, Thankom & Bendig, Mirko & Arun, Shoba, 2012. "Bequest Motives and Determinants of Micro Life Insurance in Sri Lanka," World Development, Elsevier, vol. 40(8), pages 1700-1711.
    14. Attakora-Amaniampong Elvis & Salakpi Andrews & Quansah Joseph Y.D., 2015. "Abysmal Insurance Patronage for Residential Properties in Ghana," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 5(9), pages 125-144, September.
    15. Lin, Wanchuan & Meng, Juanjuan & Weng, Xi, 2020. "Formal insurance and informal risk sharing dynamics," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 837-863.
    16. Agier, Isabelle & Ly, Antarou & Kadio, Kadidiatou & Kouanda, Seni & Ridde, Valéry, 2016. "Endorsement of universal health coverage financial principles in Burkina Faso," Social Science & Medicine, Elsevier, vol. 151(C), pages 157-166.
    17. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
    18. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2017. "Nudging Households to Take Up Health Insurance: Evidence from a Randomized Experiment in Burkina Faso," IZA Discussion Papers 10744, Institute of Labor Economics (IZA).
    19. Binagwaho, Agnes & Hartwig, Renate & Ingeri, Denyse & Makaka, Andrew, 2012. "Mutual health insurance and its contribution to improving child health in Rwanda," Passauer Diskussionspapiere, Volkswirtschaftliche Reihe V-66-12, University of Passau, Faculty of Business and Economics.
    20. Elder, Sara D. & Zerriffi, Hisham & Le Billon, Philippe, 2012. "Effects of Fair Trade Certification on Social Capital: The Case of Rwandan Coffee Producers," World Development, Elsevier, vol. 40(11), pages 2355-2367.
    21. Mladovsky, Philipa & Mossialos, Elias, 2008. "A Conceptual Framework for Community-Based Health Insurance in Low-Income Countries: Social Capital and Economic Development," World Development, Elsevier, vol. 36(4), pages 590-607, April.
    22. Mladovsky, Philipa, 2014. "Why do people drop out of community-based health insurance?: findings from an exploratory household survey in Senegal," LSE Research Online Documents on Economics 55820, London School of Economics and Political Science, LSE Library.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Goudge, Jane & Gilson, Lucy, 2005. "How can trust be investigated? Drawing lessons from past experience," Social Science & Medicine, Elsevier, vol. 61(7), pages 1439-1451, October.
    2. Dercon, Stefan & De Weerdt, Joachim & Bold, Tessa & Pankhurst, Alula, 2006. "Group-based funeral insurance in Ethiopia and Tanzania," World Development, Elsevier, vol. 34(4), pages 685-703, April.
    3. Xiao Yu Wang, 2014. "Risk Sorting, Portfolio Choice, and Endogenous Informal Insurance," NBER Working Papers 20429, National Bureau of Economic Research, Inc.
    4. Miguel, Edward A. & Gertler, Paul & Levine, David I., 2003. "Did Industrialization Destroy Social Capital in Indonesia?," Center for International and Development Economics Research, Working Paper Series qt9kt2m860, Center for International and Development Economics Research, Institute for Business and Economic Research, UC Berkeley.
    5. Jalan, Jyotsna & Ravallion, Martin, 2001. "Behavioral responses to risk in rural China," Journal of Development Economics, Elsevier, vol. 66(1), pages 23-49, October.
    6. Jeffrey A. Flory, 2011. "Micro-Savings & Informal Insurance in Villages: How Financial Deepening Affects Safety Nets of the Poor, A Natural Field Experiment," Working Papers 2011-008, Becker Friedman Institute for Research In Economics.
    7. Pascaline Dupas & Jonathan Robinson, 2013. "Savings Constraints and Microenterprise Development: Evidence from a Field Experiment in Kenya," American Economic Journal: Applied Economics, American Economic Association, vol. 5(1), pages 163-192, January.
    8. Machiko Nissanke & Ernest Aryeetey, 2006. "Institutional Analysis of Financial Market Fragmentation in Sub-Saharan Africa: A Risk-Cost Configuration Approach," WIDER Working Paper Series RP2006-87, World Institute for Development Economic Research (UNU-WIDER).
    9. Jiménez, Wilson & Gray-Molina, George & Yáñez, Ernesto & Pérez de Rada, Ernesto, 1999. "Pobreza y activos en Bolivia: ¿Qué rol juega el capital social?," IDB Publications (Working Papers) 6122, Inter-American Development Bank.
    10. Powell-Jackson, Timothy & Hanson, Kara & Whitty, Christopher J.M. & Ansah, Evelyn K., 2014. "Who benefits from free healthcare? Evidence from a randomized experiment in Ghana," Journal of Development Economics, Elsevier, vol. 107(C), pages 305-319.
    11. Leyla Dinç & Fatoş Korkmaz & Erdem Karabulut, 2013. "A Validity and Reliability Study of the Multidimensional Trust in Health-Care Systems Scale in a Turkish Patient Population," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 113(1), pages 107-120, August.
    12. Yasuyuki Sawada, 2007. "The impact of natural and manmade disasters on household welfare," Agricultural Economics, International Association of Agricultural Economists, vol. 37(s1), pages 59-73, December.
    13. Ozawa, Sachiko & Sripad, Pooja, 2013. "How do you measure trust in the health system? A systematic review of the literature," Social Science & Medicine, Elsevier, vol. 91(C), pages 10-14.
    14. Felipe Kast & Dina Pomeranz, 2013. "Saving More to Borrow Less: Experimental Evidence from Access to Formal Savings Accounts in Chile," Harvard Business School Working Papers 14-001, Harvard Business School, revised Jun 2014.
    15. AMANKWAH, ERNEST & Gockel, Fritz Augustine & Osei-Assibey, Eric, 2019. "Pareto Superior dimension of Rotating Savings and Credit Associations (ROSCAs) in Ghana: Evidence from Asunafo North Municipality of Ghana," MPRA Paper 96308, University Library of Munich, Germany.
    16. Hollis, Aidan & Sweetman, Arthur, 1998. "Microcredit in Prefamine Ireland," Explorations in Economic History, Elsevier, vol. 35(4), pages 347-380, October.
    17. Ravallion, Martin, 2003. "Targeted transfers in poor countries : revisiting the tradeoffs and policy options," Policy Research Working Paper Series 3048, The World Bank.
    18. Matteo Bobba, 2013. "Liquidity, Risk, and Occupational Choices," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 80(2), pages 491-511.
    19. George Gray-Molina & Ernesto Perez de Rada & Wilson Jimenez & Ernesto Yáñez, 1999. "Pobreza y activos en Bolivia: Qué rol juega el capital social?," Research Department Publications 3054, Inter-American Development Bank, Research Department.
    20. Santos, Paulo & Barrett, Christopher B., 2011. "Persistent poverty and informal credit," Journal of Development Economics, Elsevier, vol. 96(2), pages 337-347, November.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1430-1438. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.