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Enrollment in community based health insurance schemes in rural Bihar and Uttar Pradesh, India

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  • Panda, P.
  • Chakraborty, A.
  • Dror, D.M.
  • Bedi, A.S.

Abstract

This paper assesses insurance uptake in three community based health insurance (CBHI) schemes located in rural parts of two of India’s poorest states and offered through women’s self-help groups (SHGs). We examine what drives uptake, the degree of inclusive practices of the schemes, and the influence of health status on enrollment. The most important finding is that a household’s socio-economic status does not appear to substantially inhibit uptake. In some cases Scheduled Caste/ Scheduled Tribe (SC/ST) households are more likely to enroll. Second, households with greater financial liabilities find insurance more attractive. Third, access to the hospital insurance scheme (RSBY) does not dampen CBHI uptake, suggesting that the potential for greater development of insurance markets and products beyond existing ones would respond to a need. Fourth, recent episodes of illness and selfassessed health status do not influence uptake. Fifth, insurance coverage is prioritized within households, with the household head, the spouse of the household head and both male and female children of the household head, more likely to be insured as compared to other relatives. Sixth, offering insurance through women’s SHGs appears to mitigate concerns about the inclusiveness and sustainability of CBHI schemes. Given the pan-Indian spread of SHGs, offering insurance through such groups offers the potential to scale-up CBHI.

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Bibliographic Info

Paper provided by International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague in its series ISS Working Papers - General Series with number 555.

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Date of creation: 30 Mar 2013
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Handle: RePEc:ems:euriss:39494

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Keywords: Bihar; Uttar Pradesh; community-based health insurance; enrollment; health microinsurance; rural India; self-help groups;

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  1. Supriya Garikipati, 2012. "Microcredit and Women's Empowerment: Through the Lens of Time-Use Data from Rural India," Development and Change, International Institute of Social Studies, vol. 43(3), pages 719-750, 05.
  2. Robyn, Paul Jacob & Fink, Günther & Sié, Ali & Sauerborn, Rainer, 2012. "Health insurance and health-seeking behavior: Evidence from a randomized community-based insurance rollout in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 75(4), pages 595-603.
  3. Wagstaff, Adam & Lindelow, Magnus & Gao Jun & Xu Ling & Qian Juncheng, 2007. "Extending health insurance to the rural population : an impact evaluation of China's new cooperative medical scheme," Policy Research Working Paper Series 4150, The World Bank.
  4. Mebratie, A.D. & Sparrow, R.A. & Alemu, G. & Bedi, A.S., 2013. "Community-Based Health Insurance Schemes," ISS Working Papers - General Series 568, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  5. Jain Nishant & Bhat Ramesh, . "Factoring affecting the Demand for Health Insurance in a Micro Insurance Scheme," IIMA Working Papers WP2006-07-02, Indian Institute of Management Ahmedabad, Research and Publication Department.
  6. Supriya Garikipati, 2011. "Microcredit and Women’s Empowerment: Through the Lens of Time Use Data from Rural India," Working Papers CEB 11-034, ULB -- Universite Libre de Bruxelles.
  7. Dror, David Mark & Radermacher, Ralf & Koren, Ruth, 2007. "Willingness to pay for health insurance among rural and poor persons: Field evidence from seven micro health insurance units in India," Health Policy, Elsevier, vol. 82(1), pages 12-27, June.
  8. Seiro ITO & Hisaki KONO, 2010. "Why Is The Take-Up Of Microinsurance So Low? Evidence From A Health Insurance Scheme In India," The Developing Economies, Institute of Developing Economies, vol. 48(1), pages 74-101.
  9. Dror, David Mark & Koren, Ruth & Ost, Alexander & Binnendijk, Erika & Vellakkal, Sukumar & Danis, Marion, 2007. "Health insurance benefit packages prioritized by low-income clients in India: Three criteria to estimate effectiveness of choice," Social Science & Medicine, Elsevier, vol. 64(4), pages 884-896, February.
  10. Bendig, Mirko & Arun, Thankom Gopinath, 2011. "Enrolment in Micro Life and Health Insurance: Evidences from Sri Lanka," IZA Discussion Papers 5427, Institute for the Study of Labor (IZA).
  11. Rebecca L. Thornton & Laurel E. Hatt & Erica M. Field & Mursaleena Islam & Freddy Solís Diaz & Martha Azucena González, 2010. "Social security health insurance for the informal sector in Nicaragua: a randomized evaluation," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 181-206, September.
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