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Uptake of Health Insurance and the Productive Safety Net Program in Rural Ethiopia

Author

Listed:
  • Shigute, Zemzem

    () (ISS, Erasmus University Rotterdam)

  • Mebratie, Anagaw Derseh

    () (ISS, Erasmus University Rotterdam)

  • Sparrow, Robert

    () (Wageningen University)

  • Yilma, Zelalem

    () (ISS, Erasmus University Rotterdam)

  • Alemu, Getnet

    () (University of Addis Ababa, Ethiopia)

  • Bedi, Arjun S.

    () (ISS, Erasmus University Rotterdam)

Abstract

Due to lack of well-developed insurance, credit and labor markets, rural families in Ethiopia are exposed to a range of covariate and idiosyncratic risks. In 2005, to deal with the consequences of covariate risks, the government implemented the Productive Safety Net Program (PSNP) - an active labor market program to build rural assets, and in 2011, to mitigate the financial consequences of ill-health, the government introduced a pilot Community Based Health Insurance (CBHI) Scheme. This paper explores whether scheme uptake and retention is affected by access to the PSNP. Based on several rounds of household level panel data and qualitative information, the analysis shows that participating in the PSNP increases the probability of CBHI uptake by 24 percentage points and enhances scheme retention by 10 percentage points. Analysis of the channels through which the PSNP influences CBHI uptake indicates that the bulk of the effect may be attributed to explicit and implicit pressure applied by government officials on PSNP beneficiaries. Whether this is a desirable approach is debatable. Nevertheless, the results suggest that membership in existing social protection programs may be leveraged to spread new schemes and potentially accelerate poverty reduction efforts.

Suggested Citation

  • Shigute, Zemzem & Mebratie, Anagaw Derseh & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2016. "Uptake of Health Insurance and the Productive Safety Net Program in Rural Ethiopia," IZA Discussion Papers 9833, Institute for the Study of Labor (IZA).
  • Handle: RePEc:iza:izadps:dp9833
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    References listed on IDEAS

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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, March.
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    Cited by:

    1. Shigute, Zemzem & Strupat, Christoph & Burchi, Francesco & Alemu, Getnet & Bedi, Arjun S., 2017. "The Joint Effects of a Health Insurance and a Public Works Scheme in Rural Ethiopia," IZA Discussion Papers 10939, Institute for the Study of Labor (IZA).
    2. Hirvonen, Kalle & Bossuyt, Anne & Pigois, Remy, 2017. "Complementarities between social protection and health sector policies: Evidence from the Productive Safety Net Program in Ethiopia," ESSP working papers 112, International Food Policy Research Institute (IFPRI).
    3. repec:eee:socmed:v:200:y:2018:i:c:p:145-155 is not listed on IDEAS

    More about this item

    Keywords

    productive safety net program; active labor market program; Ethiopia; community based health insurance; uptake of health insurance;

    JEL classification:

    • J65 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment Insurance; Severance Pay; Plant Closings
    • J48 - Labor and Demographic Economics - - Particular Labor Markets - - - Particular Labor Markets; Public Policy
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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