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Renewing membership in three community-based health insurance schemes in rural India

Author

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  • Panda, P.
  • Chakraborty, A.
  • Raza, W.A.
  • Bedi, A.S.

Abstract

Low renewal rate is a key challenge facing the sustainability of Community-based Health Insurance (CBHI) schemes. While there is a large literature on initial enrolment into such schemes, there is limited evidence on the factors that impede renewal. This paper uses longitudinal data to analyse what determines renewal, both one and two years after the introduction of three CBHI schemes, which have been operating in rural Bihar and Uttar Pradesh since 2011. We find that initial scheme uptake is about 23-24 % and that two years after scheme operation, only about 20 % of the initial enrolees maintain their membership. A household’s socio-economic status does not seem to play a large role in impeding renewal. In some instances, a greater understanding of the scheme boosts renewal. The link between health status and use of health care in maintaining renewal is mixed. The clearest effect is that individuals living in households that have received benefits from the scheme are substantially more likely to renew their contracts. We find that having access to a national health insurance scheme is not a substitute for the CBHI. We conclude that the low retention rates may be attributed to limited benefit packages, slow claims processing times and the gaps between the amounts claimed and amounts paid out by insurance.

Suggested Citation

  • Panda, P. & Chakraborty, A. & Raza, W.A. & Bedi, A.S., 2015. "Renewing membership in three community-based health insurance schemes in rural India," ISS Working Papers - General Series 608, International Institute of Social Studies of Erasmus University Rotterdam (ISS), The Hague.
  • Handle: RePEc:ems:euriss:77965
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    References listed on IDEAS

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    4. Dong, Hengjin & De Allegri, Manuela & Gnawali, Devendra & Souares, Aurélia & Sauerborn, Rainer, 2009. "Drop-out analysis of community-based health insurance membership at Nouna, Burkina Faso," Health Policy, Elsevier, vol. 92(2-3), pages 174-179, October.
    5. 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.
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    7. David Mark Dror, 2018. "Enrollment in Community-based Health Insurance Schemes in Rural Bihar and Uttar Pradesh, India," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 17, pages 345-363, World Scientific Publishing Co. Pte. Ltd..
    8. Tara Sinha & M. Kent Ranson & Falguni Patel & Anne Mills, 2007. "Why have the members gone? Explanations for dropout from a community-based insurance scheme," Journal of International Development, John Wiley & Sons, Ltd., vol. 19(5), pages 653-665.
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    10. Criel, Bart & Waelkens, Maria Pia, 2003. "Declining subscriptions to the Maliando Mutual Health Organisation in Guinea-Conakry (West Africa): what is going wrong?," Social Science & Medicine, Elsevier, vol. 57(7), pages 1205-1219, October.
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    Cited by:

    1. Koloma, Yaya, 2021. "Impact of Mutual Health Insurance on Urban Households Health Expenses and Vulnerability in Burkina Faso," EconStor Preprints 234465, ZBW - Leibniz Information Centre for Economics.
    2. Wameq A. Raza & Ellen van de Poel & Arjun Bedi & Frans Rutten, 2016. "Impact of Community‐based Health Insurance on Access and Financial Protection: Evidence from Three Randomized Control Trials in Rural India," Health Economics, John Wiley & Sons, Ltd., vol. 25(6), pages 675-687, June.
    3. Lazarus MUCHABAIWA & Lloyd CHIGUSIWA & Samuel BINDU & Victoria MUDAVANHU & David DAMIYANO & Bongani Edwin MUSHANYURI, 2017. "Feasibility and Sustainability of Community Based Health Insurance in Rural Areas. Case Study of Musana, Zimbabwe," Expert Journal of Finance, Sprint Investify, vol. 5(1), pages 73-85.

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    Keywords

    community-based health insurance; renewing membership; rural India;
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