Linking Social Protection Schemes: The Joint Effects of a Public Works and a Health Insurance Programme in Ethiopia

Abstract

In developing countries and in particular in sub-Saharan Africa, social protection schemes tend to operate in silos. However, schemes targeting the same geographical areas may have synergies that have not yet been examined, and which are worth scrutinising. This paper contributes to this knowledge gap by examining the joint impacts of two social protection programmes in Ethiopia, that is, the Productive Safety Net Programme and a Community Based Health Insurance Scheme. Based on three rounds of individual level panel data and several rounds of qualitative interviews, we find that individuals covered by both programmes, as opposed to neither or only one of the two programmes, provide greater labour supply, have larger livestock holdings, and have a lower amount of outstanding loans. Furthermore, joint participation is associated with greater use of modern health care facilities as compared to participating only in the safety net programme. These results show that bundling of interventions enhances protection against multiple risks and that linking social protection schemes yields more than the sum of their individual effects.

The short‐term economywide impacts of COVID‐19 in Africa: Insights from Ethiopia

“…The country can learn a lot from the economic recovery practices from the recurrent catastrophic shocks it experienced over the past 5 years before COVID‐19—floods in 2014; the worst El Nino in 50 years in 2015/2016; drought in 2017; and desert locust invasion in 2019/2020 altogether affected the livelihoods of more than 25 million people (Nega et al, 2010; Shigute et al, 2018; UN, 2020). During these times, recovery practices in the country focused on social protection of the most vulnerable, emergency seed distribution, small‐scale irrigation projects, disaster risk reduction—including developing contingency plans—and strengthening government infrastructure (Nega et al, 2010; Shigute et al, 2018). In the past, this has been performed in coordination with local and international development partners to build sustainable livelihoods.…”

Factors affecting the uptake of community-based health insurance in Ethiopia: a systematic review

“…Participation (Iddir and Ikub) was positively related with WTJ, WTP and enrolment. 19,[30][31][32]37,42,48,[51][52][53][54][55] PSNP was encouraging to uptake, membership, and enrolment. 51,52,55 PSNP was also negatively related to CBHI uptake.…”

“…18,36,45 Households that were members in Iddir and Ikub and PSNP were found to be more willing to uptake the scheme than those households that were not. 19,[30][31][32]37,42,48,[51][52][53][54][55] Oppositely, WTU was found to be decreased in households that were members of PSNP. 18 WTU was found to be increased with individual social capital and community level horizontal trust.…”

Introduction to the Handbook on Social Protection Systems

“…The United Nations Children's Fund (UNICEF) equally highlights the importance of coordination but emphasises the overarching goals of systems by defining a social protection system as: 'a network of responses, that take a multi-pronged and coordinated approach to the multiple and compounding vulnerabilities faced by children and their families' (UNICEF 2012, 42). The combination of programmes should thus be more than the sum of its parts (Pace et al 2017;Shigutea et al 2020), which is also postulated by UNDP (2016, 44): a 'social protection system should be focused on how programmes interact and complement each other across objectives'. This vision is supported by the FAO (2017) which, however, subsumes not only social protection schemes under 'parts' but also considers livelihood promotion interventions as part of the system.…”