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Community-based health financing and child stunting in rural Rwanda

Author

Listed:
  • Lu, C.
  • Mejia-Guevara, I.
  • Hill, K.
  • Farmer, P.
  • Subramanian, S.V.
  • Binagwaho, A.

Abstract

Objectives. We analyzed the likelihood of rural children (aged 6-24 months) being stunted according to whether they were enrolled in Mutuelles, a community-based health-financing program providing health insurance to rural populations and granting them access to health care, including nutrition services. Methods. We retrieved health facility data from the District Health System Strengthening Tool and calculated the percentage of rural health centers that provided nutrition-related services required by Mutuelles' minimum service package. We used data from the 2010 Rwanda Demographic and Health Survey and performed multilevel logistic analysis to control for clustering effects and sociodemographic characteristics. The final sample was 1061 children. Results. Among 384 rural health centers, more than 90% conducted nutrition-related campaigns and malnutrition screening for children. Regardless of poverty status, the risk of being stunted was significantly lower (odds ratio = 0.60; 95% credible interval = 0.41, 0.83) for Mutuelles enrollees. This finding was robust to various model specifications (adjusted for Mutuelles enrollment, poverty status, other variables) or estimation methods (fixed and random effects). Conclusions. This study provides evidence of the effectiveness of Mutuelles in improving child nutrition status and supported the hypothesis about the role of Mutuelles in expanding medical and nutritional care coverage for children.

Suggested Citation

  • Lu, C. & Mejia-Guevara, I. & Hill, K. & Farmer, P. & Subramanian, S.V. & Binagwaho, A., 2016. "Community-based health financing and child stunting in rural Rwanda," American Journal of Public Health, American Public Health Association, vol. 106(1), pages 49-55.
    • Handle: RePEc:aph:ajpbhl:10.2105/ajph.2015.302913_5
    DOI: 10.2105/AJPH.2015.302913
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    Cited by:

    1. Anteneh, Zecharias & Celidoni, Martina & Rocco, Lorenzo, 2023. "Pathways to Better Health? Assessing the Impact of Ethiopian Community-Based Health Insurance on Children Health Outcomes," GLO Discussion Paper Series 1299, Global Labor Organization (GLO).
    2. Nathanael Ojong, 2019. "Healthcare Financing in Rural Cameroon," Societies, MDPI, vol. 9(4), pages 1-12, November.
    3. Nshakira-Rukundo, Emmanuel & Mussa, Essa Chanie & Gerber, Nicolas & von Braun, Joachim, 2020. "Impact of voluntary community-based health insurance on child stunting: Evidence from rural Uganda," Social Science & Medicine, Elsevier, vol. 245(C).
    4. Kai Liu & Benjamin Cook & Chunling Lu, 2019. "Health inequality and community-based health insurance: a case study of rural Rwanda with repeated cross-sectional data," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 64(1), pages 7-14, January.

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