Community-based health insurance and social capital: a review

Donfouet, Hermann Pythagore Pierre; Mahieu, Pierre-Alexandre

doi:10.1186/2191-1991-2-5

Cited by 57 publications

(58 citation statements)

References 21 publications

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“…The higher likelihood of NGO members joining the Chakaria health card scheme might also be indicative of the in-built solidarity that the members of such development programs share. Earlier studies have also found the success of MHI schemes to be dependent on the level of social capital [2,37,38]. MHI schemes can tap into the solidarity among the different groups of people.…”

Section: Discussionmentioning

confidence: 99%

Who enrols in voluntary micro health insurance schemes in low-resource settings? Experience from a rural area in Bangladesh

Mahmood

Hanifi

Mia

et al. 2018

Global Health Action

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Background: Micro health insurance (MHI) has proved to be a potential health-financing tool for many developing countries. Bangladesh also included MHI in its current health-financing strategy which aims to achieve universal health coverage. However, low uptake, low renewal and high dropouts have historically challenged financial sustainability of these schemes. Objective: This study aims to identify factors influencing people from low-resource settings, particularly those from Bangladesh, to enrol in MHI schemes. Methods: The study analyses the ‘Amader Shasthya’ MHI scheme operating in Chakaria, a sub-district under Cox’s Bazar district, Bangladesh. A household survey was carried out during May–June 2016 among 2,000 households from the scheme coverage area. The Outreville’s insurance-demand framework was used to identify enrolment influencing factors. Multivariate logistic regression analysis was carried out to identify significant influencing factors of enrolment. Results: Enrolment influencing factors were identified in four dimensions: economic, socio-cultural, demographic and structural. Households with the main income earner having 10+ years of schooling (odds 1.9 [CI 1.2–2.9] compared to illiterate), having financial literacy (odds 1.5 [CI 1.2–1.8] compared to financially illiterate) and being a public/private service holder (odds 1.6 [CI 1.1–2.4] compared to menial labour) were more likely to enrol. Membership in development programmes of NGOs also influenced enrolment decision significantly (odds 1.3 [CI 1.0–1.5]). The presence of chronic illness in household encouraged enrolment (odds 1.5 [CI 1.2–1.8]). Households living closer to health centres were more likely to enrol (odds 2.1 [CI 1.6–2.7]) compared to those living further away. Conclusion: The findings are expected to have significant implications in terms of designing similar health insurance schemes, particularly in terms of designing demand-driven and context adapted schemes that have greater potential to attract a larger client pool, ensure effective risk pooling and eventually expedite the achievement of universal health coverage in low-resource settings.

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Section: Discussionmentioning

confidence: 99%

Who enrols in voluntary micro health insurance schemes in low-resource settings? Experience from a rural area in Bangladesh

Mahmood

Hanifi

Mia

et al. 2018

Global Health Action

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“…Regarding the impact of social capital on the demand for CBHI, prior research suggests that social capital is an important asset that contributes not only to success but also to the increased demand and WTP for CBHI at the community level (Donfouet & Mahieu, 2012). This is because social capital facilitates the effective functioning and sustainability of CBHI (Donfouet, Essombè, Mahieu, & Malin, 2011a; Zhang, Wang, Wang, & Hsiao, 2006).…”

Section: Social Capital and Cbhimentioning

confidence: 99%

“…Moreover, in exploring the effect of social capital on willingness to pay for community-based health insurance in rural Cameroon, Donfouet et al (2011a) found that willingness to pay and demand for CBHI services were higher among communities with sufficient stocks of social capital than otherwise. Also, in a review of recent developments that address the link between CBHI and social capital, Donfouet and Mahieu (2012) found that higher levels of social capital in the form of social ties at the community level have positive and significant impacts on household's decision to join a CBHI. However, Donfouet and Mahieu, also suggest that although social ties among community members could benefit CBHI, may as well be detrimental to CBHI if members hold negative perceptions towards the scheme.…”

Section: Social Capital and Cbhimentioning

confidence: 99%

“…Among the key features of social capital that contribute to health outcomes is the trust between members (Donfouet & Mahieu, 2012). This is because trust is a minimum requisite for the formation of any social connections and interactions (Ghosh & Ray, 1996).…”

Section: Independent Variablesmentioning

confidence: 99%

“…Accordingly, social protection is increasingly becoming a significant component of poverty reduction strategies to reduce susceptibility to socioeconomic, natural and other shocks, especially among the rural dwellers CBH is a relatively new approach in the provision of health services to the poor. Among other factors, CBHIs emerged from the limitations of the microcredit programmes and conventional health insurance scheme's failure to protect low-income households and vulnerable rural population from ~ 51 ~ health shocks and non-use of health services (Ekman, 2004;Carrin, Waelkens, & Criel, 2005;Donfouet & Mahieu, 2012). CBHIs are non-profit and voluntary membership health insurance schemes aimed at protecting the poor and vulnerable against the high costs of seeking medical care and treatment.…”

Section: Introductionmentioning

confidence: 99%

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Social Capital and Willingness to Pay for Community Based Health Insurance: Empirical Evidence from Rural Tanzania

Tundui

Macha²

2014

JFE

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This study examines the effect of social capital on willingness to pay (WTP) for health services provided through community based health insurance schemes (Community Health Fund) in Tanzania. The study covered 274 household heads. We use probit regression analysis to model the relationship between the predictors and our outcome variable. Our results have shown that with the exception of religion, all other social capital variables have a positive and significant impact on the WTP for the Community Health Fund (CHF). Specifically, membership in social organisations and networks, trust among community members and trust of community members on scheme management are positively and significantly related to WTP. On the other hand, the age, education level, household size and number of children and participation in health insurance are not predicting WTP for CHF. Taken together, these results suggest that enhancing access to health care services in the rural areas and the sustainability of CHF would require building appropriate forms of social capital at individual and community levels. Specifically, CHF may increase enrolment through the existing social organisations and associations. Similarly, CHFs may well increase their membership if the avenues for trust building are created and nurtured. JEL Classifications: I1, I3

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Effect of informal financial support for health care on health Insurance uptake: Evidence from a mixed‐methods study in Tamale metropolis of northern Ghana

Alhassan

2018

Health Planning & Management

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Attempts to study the determinants of health insurance enrollment in resource-poor settings have often given less consideration to the potential influence of informal risk-sharing systems on individuals and households' decisions about health insurance. This paper contributes to existing discussions in this area by examining the effect of informal financial support for health care, an example of informal risk-sharing arrangement, on enrollment in the Ghana National Health Insurance Scheme (NHIS). It is based on a mixed-methods research in Tamale metropolis of northern Ghana. The study found widespread availability and reliance on informal support among low-income households to finance out-of-pocket health-care expenditure. Informal financial support for enrollment into the NHIS was noted to be less available. The study further found less strong but suggestive evidence that the perceived availability of informal financial support for health care by individuals diminishes their enrollment in the NHIS. The paper emphasizes the need for theory and policy on health insurance uptake in resource-constrained settings to consider existing informal risk-sharing arrangements as much as other known determinants of enrollment.

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Community-based health insurance and social capital: a review

Cited by 57 publications

References 21 publications

Who enrols in voluntary micro health insurance schemes in low-resource settings? Experience from a rural area in Bangladesh

Who enrols in voluntary micro health insurance schemes in low-resource settings? Experience from a rural area in Bangladesh

Social Capital and Willingness to Pay for Community Based Health Insurance: Empirical Evidence from Rural Tanzania

Effect of informal financial support for health care on health Insurance uptake: Evidence from a mixed‐methods study in Tamale metropolis of northern Ghana

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