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The Joint Effects of a Health Insurance and a Public Works Scheme in Rural Ethiopia

Listed author(s):
  • Shigute, Zemzem

    ()

    (ISS, Erasmus University Rotterdam)

  • Strupat, Christoph

    ()

    (German Development Institute)

  • Burchi, Francesco

    ()

    (German Development Institute)

  • Alemu, Getnet

    ()

    (University of Addis Ababa, Ethiopia)

  • Bedi, Arjun S.

    ()

    (ISS, Erasmus University Rotterdam)

Registered author(s):

    Rural households in Ethiopia are exposed to a variety of covariate and idiosyncratic risks. In 2005, the Ethiopian government introduced the Productive Safety Net Program (PSNP) and in 2011 launched the Community Based Health Insurance Scheme (CBHI). This paper analyses the interaction between the two schemes and their joint effect on health care utilization, labor supply, asset accumulation and borrowing. The empirical analysis relies on three rounds of individual-level panel data collected in 2011, 2012 and 2013 and on several rounds of qualitative work. We find that individuals covered by both programs, as opposed to neither, are 5 percentage points more likely to use outpatient care and are 21 percentage points more likely to participate in off-farm work. Furthermore, participation in both programs is associated with a 5 percent increase in livestock, the main household asset, and a 27 percent decline in debt. These results suggest that at least in Ethiopia bundling of interventions enhances protection against multiple risks and shows the potential of linked social protection schemes.

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    Paper provided by Institute for the Study of Labor (IZA) in its series IZA Discussion Papers with number 10939.

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    Length: 42 pages
    Date of creation: Aug 2017
    Handle: RePEc:iza:izadps:dp10939
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    1. Syed Abdul Hamid & Jennifer Roberts & Paul Mosley, 2011. "Can Micro Health Insurance Reduce Poverty? Evidence From Bangladesh," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 78(1), pages 57-82, 03.
    2. 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.
    3. Jere R. Behrman & John Hoddinott, 2005. "Programme Evaluation with Unobserved Heterogeneity and Selective Implementation: The Mexican "PROGRESA" Impact on Child Nutrition," Oxford Bulletin of Economics and Statistics, Department of Economics, University of Oxford, vol. 67(4), pages 547-569, 08.
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    8. Cristian C. Baeza & Truman G. Packard, 2006. "Beyond Survival : Protecting Households from Health Shocks in Latin America," World Bank Publications, The World Bank, number 7120, October.
    9. Salvatore Di Falco & Marcella Veronesi & Mahmud Yesuf, 2011. "Does Adaptation to Climate Change Provide Food Security? A Micro-Perspective from Ethiopia," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 93(3), pages 825-842.
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    11. 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.
    12. Zelalem Yilma & Anagaw Mebratie & Robert Sparrow & Degnet Abebaw & Marleen Dekker & Getnet Alemu & Arjun S. Bedi, 2014. "Coping with shocks in rural Ethiopia," Journal of Development Studies, Taylor & Francis Journals, vol. 50(7), pages 1009-1024, July.
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    20. Limwattananon, Supon & Neelsen, Sven & O'Donnell, Owen & Prakongsai, Phusit & Tangcharoensathien, Viroj & van Doorslaer, Eddy & Vongmongkol, Vuthiphan, 2015. "Universal coverage with supply-side reform: The impact on medical expenditure risk and utilization in Thailand," Journal of Public Economics, Elsevier, vol. 121(C), pages 79-94.
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