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Social protection in an aspiring ‘developmental state’: The political drivers of community-based health insurance in Ethiopia

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  • Tom Lavers

Abstract

Ethiopia has been piloting and scaling up a community-based health insurance scheme for the informal sector since 2011, alongside preparations for the launch of a social health insurance scheme for the formal sector. This paper examines the political drivers of the adoption and implementation of the scheme, based on key informant interviews with key figures involved in its elaboration. The paper argues that efforts to extend access to healthcare are linked to the ruling coalition’s longstanding focus on delivering tangible socioeconomic progress as a means of building its legitimacy and securing political support. Health insurance, meanwhile, has secured elite commitment, primarily due to the ‘ideational fit’ between this policy idea and core paradigmatic ideas underpinning the ruling coalition.

Suggested Citation

  • Tom Lavers, 2016. "Social protection in an aspiring ‘developmental state’: The political drivers of community-based health insurance in Ethiopia," Global Development Institute Working Paper Series esid-071-16, GDI, The University of Manchester.
    • Handle: RePEc:bwp:bwppap:esid-071-16
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    References listed on IDEAS

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    1. Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2015. "Enrollment in Ethiopia’s Community-Based Health Insurance Scheme," World Development, Elsevier, vol. 74(C), pages 58-76.
    2. Shigute, Zemzem & Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2017. "Uptake of health insurance and the productive safety net program in rural Ethiopia," Social Science & Medicine, Elsevier, vol. 176(C), pages 133-141.
    3. Mebratie, A.D. & Sparrow, R.A. & Debebe, Z.Y. & Alemu, G. & Bedi, A.S., 2014. "Dropping out of Ethiopia’s Community Based Health Insurance scheme," ISS Working Papers - General Series 76960, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
    4. Asfaw, Abay & Braun, Joachim von & Klasen, Stephan, 2004. "How Big is the Crowding-Out Effect of User Fees in the Rural Areas of Ethiopia? Implications for Equity and Resources Mobilization," World Development, Elsevier, vol. 32(12), pages 2065-2081, December.
    5. Tom Lavers & Sam Hickey, 2015. "Investigating the political economy of social protection expansion in Africa: At the intersection of transnational ideas and domestic politics," Global Development Institute Working Paper Series esid-047-15, GDI, The University of Manchester.
    6. repec:ilo:ilowps:487627 is not listed on IDEAS
    7. Medhane Tadesse & John Young, 2003. "TPLF: reform or decline?," Review of African Political Economy, Taylor & Francis Journals, vol. 30(97), pages 389-403, September.
    8. Giulia Mascagni, 2016. "Aid and Taxation in Ethiopia," Journal of Development Studies, Taylor & Francis Journals, vol. 52(12), pages 1744-1758, December.
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    Cited by:

    1. Chemouni, Benjamin, 2018. "The political path to universal health coverage: Power, ideas and community-based health insurance in Rwanda," World Development, Elsevier, vol. 106(C), pages 87-98.
    2. Rasmus Hundsbaek Pedersen & Thabit Jacob, 2018. "Social protection in an electorally competitive environment (2): The politics of health insurance in Tanzania," Global Development Institute Working Paper Series esid-110-18, GDI, The University of Manchester.

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