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

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  • Schneider, Pia
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    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.

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    Bibliographic Info

    Article provided by Elsevier in its journal Social Science & Medicine.

    Volume (Year): 61 (2005)
    Issue (Month): 7 (October)
    Pages: 1430-1438

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    Handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1430-1438

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    Keywords: Trust Micro-health insurance Access to care Rwanda;

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    Cited by:
    1. 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.
    2. 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.
    3. 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.
    4. 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.
    5. Delavallade, Clara, 2014. "Quality healthcare and health insurance retention: Evidence from a randomized experiment in the Kolkata slums:," IFPRI discussion papers 1352, International Food Policy Research Institute (IFPRI).
    6. 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.

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