Enrolment in Ethiopia’s Community Based Health Insurance Scheme
In June 2011, the Government of Ethiopia rolled out a pilot Community Based Health Insurance (CBHI) scheme. This paper assesses scheme uptake. We examine whether the scheme is inclusive, the role of health status in inducing enrolment and the effect of the quality of health care on uptake. By December 2012, scheme uptake had reached an impressive 45.5 percent of target households. We find that a household’s socioeconomic status does not inhibit uptake and the most food-insecure households are substantially more likely to enrol. Recent illnesses, incidence of chronic diseases and self-assessed health status do not induce enrolment, while there is a positive link between past expenditure on outpatient care and enrolment. A relative novelty is the identification of the quality of health care on enrolment. We find that the availability of medical equipment and waiting time to see a medical professional play a substantial role in determining enrolment. Focus group discussions raise concerns about the behaviour of health care providers who tend to provide preferential treatment to uninsured households. Nevertheless, the start of the pilot scheme has been impressive and despite some concerns, almost all insured households indicate their intention to renew membership and more than half of uninsured households indicate a desire to enrol. While this augurs well, the estimates suggest that expanding uptake will require continued investments in the quality of health care.
|Date of creation:||20 Dec 2013|
|Date of revision:|
|Contact details of provider:|| Postal: Kortenaerkade 12, 2518 AX Den Haag|
Phone: +31 70 4260 460
Fax: +31 70 4260 799
Web page: http://www.iss.nl/
More information through EDIRC
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Dekker, Marleen & Wilms, Annegien, 2010. "Health Insurance and Other Risk-Coping Strategies in Uganda: The Case of Microcare Insurance Ltd," World Development, Elsevier, vol. 38(3), pages 369-378, March.
- Hermann Pythagore Pierre Donfouet & Pierre-Alexandre Mahieu, 2012.
"Community-based health insurance and social capital: a review,"
- Hermann Donfouet & Pierre-Alexandre Mahieu, 2012. "Community-based health insurance and social capital: a review," Health Economics Review, Springer, vol. 2(1), pages 1-5, December.
- 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.
- Bhattamishra, Ruchira & Barrett, Christopher B., 2010. "Community-Based Risk Management Arrangements: A Review," World Development, Elsevier, vol. 38(7), pages 923-932, July.
- Mladovsky, Philipa & Mossialos, Elias, 2008. "A Conceptual Framework for Community-Based Health Insurance in Low-Income Countries: Social Capital and Economic Development," World Development, Elsevier, vol. 36(4), pages 590-607, April.
- Onwujekwe, Obinna & Onoka, Chima & Uzochukwu, Benjamin & Okoli, Chijioke & Obikeze, Eric & Eze, Soludo, 2009. "Is community-based health insurance an equitable strategy for paying for healthcare? Experiences from southeast Nigeria," Health Policy, Elsevier, vol. 92(1), pages 96-102, September.
- Mensah, Joseph & Oppong, Joseph R. & Schmidt, Christoph M., 2009.
"Ghana's National Health Insurance Scheme in the Context of the Health MDGs – An Empirical Evaluation Using Propensity Score Matching,"
Ruhr Economic Papers
157, RWI - Leibniz-Institut für Wirtschaftsforschung, Ruhr-University Bochum, TU Dortmund University, University of Duisburg-Essen.
- Joseph Mensah & Joseph R. Oppong & Christoph M. Schmidt, 2010. "Ghana's national health insurance scheme in the context of the health MDGs: an empirical evaluation using propensity score matching," Health Economics, John Wiley & Sons, Ltd., vol. 19(S1), pages 95-106, September.
- Sinha, Tara & Ranson, M. Kent & Mills, Anne J., 2007. "Protecting the Poor? The Distributional Impact of a Bundled Insurance Scheme," World Development, Elsevier, vol. 35(8), pages 1404-1421, August.
- Kent Ranson, M. & Sinha, Tara & Chatterjee, Mirai & Acharya, Akash & Bhavsar, Ami & Morris, Saul S. & Mills, Anne J., 2006. "Making health insurance work for the poor: Learning from the Self-Employed Women's Association's (SEWA) community-based health insurance scheme in India," Social Science & Medicine, Elsevier, vol. 62(3), pages 707-720, February.
- Palmer, Michael G., 2014. "Inequalities in Universal Health Coverage: Evidence from Vietnam," World Development, Elsevier, vol. 64(C), pages 384-394.
- Stefan Dercon, 2000.
"Income risk, coping strategies and safety nets,"
CSAE Working Paper Series
2000-26, Centre for the Study of African Economies, University of Oxford.
- Chetty, Raj & Looney, Adam, 2006.
"Consumption smoothing and the welfare consequences of social insurance in developing economies,"
Journal of Public Economics,
Elsevier, vol. 90(12), pages 2351-2356, December.
- Raj Chetty & Adam Looney, 2005. "Consumption Smoothing and the Welfare Consequences of Social Insurance in Developing Economies," NBER Working Papers 11709, National Bureau of Economic Research, Inc.
- Shimeles, Abebe, 2010. "Community based health insurance schemes in Africa: The case of Rwanda," Working Papers in Economics 463, University of Gothenburg, Department of Economics.
- Rajeev Ahuja & Johannes Jutting, 2004. "Are the poor too poor to demand health insurance?," Indian Council for Research on International Economic Relations, New Delhi Working Papers 118, Indian Council for Research on International Economic Relations, New Delhi, India.
- Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2015.
"Enrollment in Ethiopia’s Community-Based Health Insurance Scheme,"
Elsevier, vol. 74(C), pages 58-76.
- Derseh, A. & Sparrow, R.A. & Debebe, Z.Y. & Alemu, G. & Bedi, A.S., 2013. "Enrolment in Ethiopia’s Community Based Health Insurance Scheme," ISS Working Papers - General Series 50221, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
- Saksena, Priyanka & Antunes, Adélio Fernandes & Xu, Ke & Musango, Laurent & Carrin, Guy, 2011. "Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection," Health Policy, Elsevier, vol. 99(3), pages 203-209, March.
- Zhang, Licheng & Wang, Hong, 2008. "Dynamic process of adverse selection: Evidence from a subsidized community-based health insurance in rural China," Social Science & Medicine, Elsevier, vol. 67(7), pages 1173-1182, October.
- Smith, Kimberly V. & Sulzbach, Sara, 2008. "Community-based health insurance and access to maternal health services: Evidence from three West African countries," Social Science & Medicine, Elsevier, vol. 66(12), pages 2460-2473, June.
- Gnawali, Devendra Prasad & Pokhrel, Subhash & Sié, Ali & Sanon, Mamadou & De Allegri, Manuela & Souares, Aurélia & Dong, Hengjin & Sauerborn, Rainer, 2009. "The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso," Health Policy, Elsevier, vol. 90(2-3), pages 214-222, May.
- 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.
- Sukumar Vellakkal, 2013. "Determinants of Enrolment in Voluntary Health Insurance: Evidences from a Mixed Method Study, Kerala, India," International Journal of Financial Research, International Journal of Financial Research, Sciedu Press, vol. 4(2), pages 99-107, April.
When requesting a correction, please mention this item's handle: RePEc:ems:euriss:50221. See general information about how to correct material in RePEc.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (RePub)
If references are entirely missing, you can add them using this form.