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Demand for voluntary health insurance in developing countries: The case of Vietnam's school-age children and adolescent student health insurance program


  • Nguyen, Ha
  • Knowles, James


Many developing countries are trying to expand health insurance to achieve universal coverage, yet enrolling informal sector workers and the rural population remains a challenge. A good knowledge of factors driving demand for health insurance among these groups is therefore important. The current study contributes to this body of knowledge by analyzing demand for school-age children and adolescent student (aged 6-20) health insurance, a major voluntary health insurance scheme in Vietnam. Data were drawn form the Vietnam National Health Survey (2001-2002). We found that demand increases significantly with the expected benefits of insurance as measured by proximity to and quality of a tertiary hospital. There is a strong socio-economic gradient both at the household and commune levels, with wealthier, more educated households in better-off communes significantly more likely to purchase insurance for their children. No clear evidence of adverse selection is observed whether health status is assessed objectively or subjectively. Finally, while female heads of household are generally more prone to purchase health insurance for their children, households prioritize young children, male children, and those children with more schooling in their purchase decision. Findings emphasize the need to understand the effects of both health system factors and intra-household dynamics in resource allocation to explain the demand for health insurance in developing countries.

Suggested Citation

  • Nguyen, Ha & Knowles, James, 2010. "Demand for voluntary health insurance in developing countries: The case of Vietnam's school-age children and adolescent student health insurance program," Social Science & Medicine, Elsevier, vol. 71(12), pages 2074-2082, December.
  • Handle: RePEc:eee:socmed:v:71:y:2010:i:12:p:2074-2082

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    References listed on IDEAS

    1. Dong, Hengjin & Kouyate, Bocar & Snow, Rachel & Mugisha, Frederick & Sauerborn, Rainer, 2003. "Gender's effect on willingness-to-pay for community-based insurance in Burkina Faso," Health Policy, Elsevier, vol. 64(2), pages 153-162, May.
    2. Menno Pradhan & Fadia Saadah & Robert Sparrow, 2007. "Did the Health Card Program Ensure Access to Medical Care for the Poor during Indonesia's Economic Crisis?," World Bank Economic Review, World Bank Group, vol. 21(1), pages 125-150.
    3. David Whynes & Emma Frew & Jane Wolstenholme, 2005. "Willingness-to-Pay and Demand Curves: A Comparison of Results Obtained Using Different Elicitation Formats," International Journal of Health Economics and Management, Springer, vol. 5(4), pages 369-386, December.
    4. Ali Asgary & Ken Willis & Ali Taghvaei & Mojtaba Rafeian, 2004. "Estimating rural households’ willingness to pay for health insurance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 5(3), pages 209-215, September.
    5. Bärnighausen, Till & Sauerborn, Rainer, 2002. "One hundred and eighteen years of the German health insurance system: are there any lessons for middle- and low-income countries?," Social Science & Medicine, Elsevier, vol. 54(10), pages 1559-1587, May.
    6. Zhang, Licheng & Wang, Hong & Wang, Lushang & Hsiao, William, 2006. "Social capital and farmer's willingness-to-join a newly established community-based health insurance in rural China," Health Policy, Elsevier, vol. 76(2), pages 233-242, April.
    7. Hengjin Dong & Bocar Kouyate & John Cairns & Frederick Mugisha & Rainer Sauerborn, 2003. "Willingness-to-pay for community-based insurance in Burkina Faso," Health Economics, John Wiley & Sons, Ltd., vol. 12(10), pages 849-862.
    8. Johannes P. Jütting, 2003. "Health Insurance for the Poor?: Determinants of Participation in Community-Based Health Insurance Schemes in Rural Senegal," OECD Development Centre Working Papers 204, OECD Publishing.
    9. Xiao-Hua Ying & Teh-Wei Hu & Jane Ren & Wen Chen & Ke Xu & Jin-Hui Huang, 2007. "Demand for private health insurance in Chinese urban areas," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 1041-1050.
    10. Schmidt, Jean-Olivier & Ensor, Tim & Hossain, Atia & Khan, Salam, 2010. "Vouchers as demand side financing instruments for health care: A review of the Bangladesh maternal voucher scheme," Health Policy, Elsevier, vol. 96(2), pages 98-107, July.
    11. Paul Gertler, 2004. "Do Conditional Cash Transfers Improve Child Health? Evidence from PROGRESA's Control Randomized Experiment," American Economic Review, American Economic Association, vol. 94(2), pages 336-341, May.
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    Cited by:

    1. Dang, Thang, 2017. "The Multiple Effects of Child Health Insurance in Vietnam," MPRA Paper 78614, University Library of Munich, Germany.
    2. repec:pdc:jrnbeh:v:13:y:2017:i:2:p:182-191 is not listed on IDEAS
    3. Martin Eling & Shailee Pradhan & Joan T Schmit, 2014. "The Determinants of Microinsurance Demand," The Geneva Papers on Risk and Insurance - Issues and Practice, Palgrave Macmillan;The Geneva Association, vol. 39(2), pages 224-263, April.
    4. repec:spr:ijphth:v:62:y:2017:i:1:d:10.1007_s00038-016-0911-z is not listed on IDEAS
    5. Axel Demenet, 2016. "Can Insurance Mitigate Household Businesses’ Vulnerability to Health Shocks?," Working Papers DT/2016/10, DIAL (Développement, Institutions et Mondialisation).
    6. Annear, Peter Leslie & Ahmed, Shakil & Ros, Chhun Eang & Ir, Por, 2013. "Strengthening institutional and organizational capacity for social health protection of the informal sector in lesser-developed countries: A study of policy barriers and opportunities in Cambodia," Social Science & Medicine, Elsevier, vol. 96(C), pages 223-231.
    7. Palmer, Michael & Mitra, Sophie & Mont, Daniel & Groce, Nora, 2015. "The impact of health insurance for children under age 6 in Vietnam: A regression discontinuity approach," Social Science & Medicine, Elsevier, vol. 145(C), pages 217-226.
    8. Wagstaff, Adam & Nguyen, Ha Thi Hong & Dao, Huyen & Balesd, Sarah, 2014. "Encouraging health insurance for the informal sector : a cluster randomized trial," Policy Research Working Paper Series 6910, The World Bank.


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