Impact of Ethiopia's Community Based Health Insurance on Household Economic Welfare

Yilma, Zelalem; Mebratie, Anagaw Derseh; Sparrow, Robert; Dekker, Marleen; Alemu, Getnet; Bedi, Arjun S.

doi:10.1093/wber/lhv009

Cited by 50 publications

(51 citation statements)

References 14 publications

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“…In Amhara and Tigray, CBHI enrolees may visit any public hospital within the region. This increase the accessibility of health insurance service [25]. This study revealed that maternal age as a predictor of health insurance coverage.…”

Section: Discussionmentioning

confidence: 59%

Spatial distribution and associated factors of health insurance coverage in Ethiopia: further analysis of Ethiopia demographic and health survey, 2016

et al. 2020

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Background: Health insurance is one of the instruments to achieve universal health coverage. However, in Ethiopia, the coverage of health insurance is very low and varies from place to place as well. Therefore, exploring the spatial distribution of health insurance is important to prioritize and design targeted intervention programs in the country. Methods: A total of 16,583 reproductive age group women (15-49 years) were included in this study. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyse the purely spatial clusters of health insurance coverage. ArcGIS version 10.3 was used to visualize the distribution of health insurance coverage across the country. Mixed-effect logistic regression analysis was also used to identify predictors of health insurance coverage. Results: Health insurance coverage among women aged 15-49 years had spatial variations across the country (Moran's I: 0.115, p < 0.001). Health insurance coverage in Amhara (p < 0.001) and Tigray (p < 0.001) National Regional States clustered spatially. Reading newspapers at least once a week (Adjusted Odds Ratio (AOR) = 1.78, 95% CI: (1.18-2.68))), 40-44 years of age (AOR = 2.14, 95% CI: (1.37-3.35)), clerical working mothers (AOR = 4.33, 95% CI: (2.50-7.49)), mothers' with secondary school education (AOR = 1.77; 95% CI: (1.21-2.58)), mothers' with higher school education (AOR = 2.62; 95% CI: (1.63-4.23)), having more than 5 family members (AOR = 1.25; 95% CI: (1.01-1.55)) and richest wealth quantile (AOR = 3.43, 95% CI: (1.96-6.01)) were predictors of health insurance coverage among reproductive age group women in Ethiopia. Conclusion: Health insurance coverage was very low in Ethiopia and had spatial variations across the country. The hot spot areas with low health insurance coverage need more coherent and harmonized action such as strengthening financial protection through national health packages, sharing experience from regions which have better health insurance coverage and using mass media to increase awareness and confidence of potentials in the systems, which may encourage them to enrol.

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Section: Discussionmentioning

confidence: 59%

Spatial distribution and associated factors of health insurance coverage in Ethiopia: further analysis of Ethiopia demographic and health survey, 2016

et al. 2020

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“…Since the 1990s, many developing countries have introduced micro‐ or community‐based health insurance (CBHI) to strengthen the health care financing system for increasing access to health care and reducing the use of costly risk‐coping strategies (use of savings, sell assets, borrow money from friends and family, etc) . Since then, CBHI has received crucial attention as a mechanism of health financing and a potential alternative to the OOP payments in low and middle‐income countries …”

Section: Introductionmentioning

confidence: 99%

Adverse selection and supply‐side factors in the enrollment in community‐based health insurance in Northwest Ethiopia: A mixed methodology

Atafu

Kwon

2018

Health Planning & Management

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This study showed a possibility of adverse selection in CBHI enrollment. Additionally, perceived quality of health services, knowledge, and information (awareness) are positively associated with CBHI enrollment. Therefore, policy interventions to mitigate adverse selection as well as provision of social marketing activities are crucial to increase enrollment in CBHI. Furthermore, policy interventions that enhance the capacity of health facilities and schemes to provide the promised services are necessary.

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“…CBHI was introduced [18] and launched in Ethiopia in 2011 [29,30] and was begun to be implemented in 2011 in 13 districts of four most populous regions (Amhara, Tigray, Oromia and World Health Organization (WHO) (https://www.who.int/).…”

Section: Introductionmentioning

confidence: 99%

Factors affecting community based health insurance utilization in Ethiopia: A systematic review

Bayked¹,

Kahissay²,

Workneh³

2019

Preprint

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Background: The goal of health care financing in Ethiopia has been to achieve universal health care coverage by minimizing the catastrophic out of pocket health service expenditure. Even though the performance was not as planned, the promising strategy to achieve universal health care coverage in the informal sector was community based health insurance which was expected to cover more than 83 % of the population. So, we systematically reviewed determinants of community based health insurance utilization in Ethiopia. Methods: We searched DOAJ, EconBiz, ERIC, Google Scholar, Oxford Journals, PubMed, SpringerLink, Europe PMC, Microsoft Academic Search, OAIster and AJ including various relevant websites by March 9 to 10, 2019. We included articles regardless of their publication status with both quantitative and qualitative approaches. Results: The factors determining community based health insurance utilization in Ethiopia were found to be associated with supply side, health facility, demographic and socioeconomic predictors. Among demographic and socio-economic factors, the report of the studies regarding to gender and age was not consistent. However income, education, community participation, marriage, occupation and family size were found to be significant predictors and were positively related with the scheme’s utilization. With respect to health status and health service related factors; illness experience, benefit package, awareness level, previous out of pocket expenditure for health care service and health service status (quality, adequacy, efficiency and coverage) were significantly and positively related but premium amount, self-rated health status and bureaucratic complexity were found to be negative predictors. Conclusion: To achieve universal health care coverage through community based health insurance, it is advisable that special attention should be given to income level, education, community participation, marriage, family size, benefit package, awareness level and health service quality, premium amount and bureaucratic or governance issue.

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Impact of Ethiopia's Community Based Health Insurance on Household Economic Welfare

Cited by 50 publications

References 14 publications

Spatial distribution and associated factors of health insurance coverage in Ethiopia: further analysis of Ethiopia demographic and health survey, 2016

Spatial distribution and associated factors of health insurance coverage in Ethiopia: further analysis of Ethiopia demographic and health survey, 2016

Adverse selection and supply‐side factors in the enrollment in community‐based health insurance in Northwest Ethiopia: A mixed methodology

Factors affecting community based health insurance utilization in Ethiopia: A systematic review

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