Motivation: Social protection policies typically involve multiple sectors, ranging from food security to health care. Despite this, limited research is directed toward understanding how different social protection programmes complement each other. Purpose: We explore complementarities between three major national social protection programmes in rural Ethiopia: the Productive Safety Net Programme (PSNP), the Community Based Health Insurance (CBHI) scheme and the Health Fee Waiver (HFW) system. Approach and methods: We use secondary data from districts in which the PSNP operates to study the coverage of the CBHI and the HFW schemes. We then quantify the prevalence of health shocks reported by poor households and calculate the annual out-of-pocket (OOP) health care expenses incurred by poor households in these districts. Findings: We find limited overlap between the PSNP and the CBHI or HFW schemes. In districts in which the CBHI operates, about 22% of the PSNP households are enrolled into CBHI. For 10% of all PSNP households, the CBHI insurance premium was waived due to their poverty status. In non-CBHI districts, 3.5% of PSNP households report having benefitted from HFW. Moreover, many households report serious health shocks that resulted in loss of consumption or assets. The estimated OOP health expenditures are high, even among those households enrolled into CBHI or benefitting from HFW. Policy implications: Taken together, these findings suggest that there is scope to improve the linkages between these three major social protection programmes in Ethiopia to protect the poorest and most vulnerable households. K E Y W O R D Shealth care policy, health insurance, safety nets, social protection 1. To improve access to health services by making it more affordable. 2. To improve the quality of the health services. 3. To improve the financial viability of the health sector. 4. To engage and strengthen community participation in the management of health services. 5. To strengthen the capacity of the national health sector.The decision to enrol into the scheme is left to kebeles (sub-districts), which, together with woreda officials, manage the scheme (EHIA, 2015). Once the kebele has joined the scheme, each household 2 These selection criteria were set to ensure that the CBHI scheme would be implemented well during the pilot phase. This in turn increases the likelihood that the scheme has a positive impact on its beneficiaries. It is important to note that these same criteria do not necessarily apply once the scheme is scaled up.

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