Social Protection in Rural Areas of Developing Countries: Investigating the Impact of Community Based Health Insurance in Rural Senegal

Community based health insurance schemes are becoming increasingly recognized as an instrument which help farmers in rural areas of low income countries to better manage health. Health risks present a permanent threat to the income earning capacity of poor people. Beside direct economic cost for treatment and lost working time, indirect cost such as a reduction in labor supply materialize which increases the vulnerability of the household. It is often hypothezised that community based health insurance improve social protection, but quantitative analysis is largely missing. Against this background, this paper analyzes if members in a mutual health insurance scheme have a better access to health care than non-members taking "les mutuelles de santes" (mutual health organization) in rural Senegal as an example. Limited dependent and log linear regressions are used to capture the impact of health insurance on the probability of visiting a health care provider and the out-of-pocket expenditure at the point of use . The results of the analysis show that while community based health insurance schemes reach otherwise excluded people, the poorest of the poor in the communities are not covered. Regarding the impact on the access to health care, members have a higher probability of using hospitalization services compared to non-members and pay substantially less when they need care. Given the results from this study, community financing schemes have the potential to improve the risk management capacity of rural households.