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Health Insurance in Sub-Saharan Africa: A Scoping Review of the Methods Used to Evaluate its Impact

Author

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  • Stéphanie Degroote

    (French Institute For Research on Sustainable Development (IRD), IRD Paris Descartes University (CEPED))

  • Valery Ridde

    (French Institute For Research on Sustainable Development (IRD), IRD Paris Descartes University (CEPED)
    Paris Sorbonne Cities University)

  • Manuela Allegri

    (Heidelberg Institute of Global Health, University Hospital and Medical Faculty, Heidelberg University)

Abstract

We conducted a scoping review with the objective of synthesizing available literature and mapping what designs and methods have been used to evaluate health insurance reforms in sub-Saharan Africa. We systematically searched for scientific and grey literature in English and French published between 1980 and 2017 using a combination of three key concepts: “Insurance” and “Impact evaluation” and “sub-Saharan Africa”. The search led to the inclusion of 66 articles with half of the studies pertaining to the evaluation of National Health Insurance schemes, especially the Ghanaian one, and one quarter pertaining to Community-Based Health Insurance and Mutual Health Organization schemes. Sixty-one out of the 66 studies (92%) included were quantitative studies, while only five (8%) were defined as mixed methods. Most studies included applied an observational design (n = 37; 56%), followed by a quasi-experimental (n = 27; 41%) design; only two studies (3%) applied an experimental design. The findings of our scoping review are in line with the observation emerging from prior reviews focused on content in pointing at the fact that evidence on the impact of health insurance is still relatively weak as it is derived primarily from studies relying on observational designs. Our review did identify an increase in the use of quasi-experimental designs in more recent studies, suggesting that we could observe a broadening and deepening of the evidence base on health insurance in Africa over the next few years.

Suggested Citation

  • Stéphanie Degroote & Valery Ridde & Manuela Allegri, 2020. "Health Insurance in Sub-Saharan Africa: A Scoping Review of the Methods Used to Evaluate its Impact," Applied Health Economics and Health Policy, Springer, vol. 18(6), pages 825-840, December.
  • Handle: RePEc:spr:aphecp:v:18:y:2020:i:6:d:10.1007_s40258-019-00499-y
    DOI: 10.1007/s40258-019-00499-y
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    References listed on IDEAS

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    1. Maame Esi WOODE & Marwân-Al-Qays BOUSMAH & Raouf BOUCEKKINE, 2017. "Parental Morbidity, Child Work, and Health Insurance in Rwanda," JODE - Journal of Demographic Economics, Cambridge University Press, vol. 83(1), pages 111-127, March.
    2. Strupat, Christoph, 2016. "From protection to reduction? The impact of the public health insurance scheme on child labour in Ghana," IDOS Discussion Papers 16/2016, German Institute of Development and Sustainability (IDOS).
    3. Gajate-Garrido, Gissele & Ahiadeke, Clement, 2015. "The effect of insurance enrollment on maternal and child health care utilization: The case of Ghana," IFPRI discussion papers 1495, International Food Policy Research Institute (IFPRI).
    4. Zelalem Yilma & Anagaw Mebratie & Robert Sparrow & Marleen Dekker & Getnet Alemu & Arjun S. Bedi, 2015. "Impact of Ethiopia's Community Based Health Insurance on Household Economic Welfare," The World Bank Economic Review, World Bank, vol. 29(suppl_1), pages 164-173.
    5. John Ele-Ojo Ataguba & Jane Goudge, 2012. "The Impact of Health Insurance on Health-care Utilisation and Out-of-Pocket Payments in South Africa," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 37(4), pages 633-654, October.
    6. Smith, Kimberly V. & Sulzbach, Sara, 2008. "Community-based health insurance and access to maternal health services: Evidence from three West African countries," Social Science & Medicine, Elsevier, vol. 66(12), pages 2460-2473, June.
    7. Lucy Gilson & Kara Hanson & Kabir Sheikh & Irene Akua Agyepong & Freddie Ssengooba & Sara Bennett, 2011. "Building the Field of Health Policy and Systems Research: Social Science Matters," PLOS Medicine, Public Library of Science, vol. 8(8), pages 1-6, August.
    8. Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
    9. Lisa Bagnoli, 2017. "Does National Health Insurance Improve Children's Health ?National and Regional Evidence from Ghana," Working Papers ECARES ECARES 2017-03, ULB -- Universite Libre de Bruxelles.
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    1. Chris Sampson’s journal round-up for 28th December 2020
      by Chris Sampson in The Academic Health Economists' Blog on 2020-12-28 12:00:00

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    1. Raju,Dhushyanth & Younger,Stephen D. & Dadzie,Christabel Ewuradjoa, 2023. "Social Protection Program Spending and Household Welfare in Ghana," Social Protection Discussion Papers and Notes 181666, The World Bank.

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