Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

Onwujekwe, Obinna; Onoka, Chima; Uguru, Nkoli; Nnenna, Tasie; Uzochukwu, Benjamin; Eze, Soludo; Kirigia, Joses Muthuri; Petu, Amos

doi:10.1186/1472-6963-10-162

Cited by 49 publications

(66 citation statements)

References 8 publications

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“…Some researchers have recommended that MHOs should seek to better understand consumers’ preferences and incorporate these into the design of insurance plans [11,14]. Churchill and Cohen [15] proposed that MHOs should conduct marketing campaigns to increase people’s awareness and understanding of simple insurance products.…”

Section: Introductionmentioning

confidence: 99%

Mapping of initiatives to increase membership in mutual health organizations in Benin

Turcotte-Tremblay

Haddad

Yacoubou³

et al. 2012

International Journal for Equity in Health

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IntroductionMutual health organizations (MHO) have been implemented across Africa to increase access to healthcare and improve financial protection. Despite efforts to develop MHOs, low levels of both initial enrolment and membership renewals continue to threaten their financial viability. The purpose of this study was to map initiatives implemented to increase the pool of MHO members in Benin.MethodsA multiple case study was conducted to assess MHOs supported by five major promoters in Benin. Three months of fieldwork resulted in 23 semi-structured interviews and two focus groups with MHO promoters, technicians, elected members, and health professionals affiliated with the MHOs. Fifteen non-structured interviews provided additional information and a valuable source of triangulation.ResultsMHOs have adopted a wide range of initiatives targeting different entry points and involving a variety of stakeholders. Initiatives have included new types of collective health insurance packages and efforts to raise awareness by going door-to-door and organizing health education workshops. Different types of partnerships have been established to strengthen relationships with healthcare professionals and political leaders. However, the selection and implementation of these initiatives have been limited by insufficient financial and human resources.ConclusionsThe study highlights the importance of prioritizing sustainable strategies to increase MHO membership. No single MHO initiative has been able to resolve the issue of low membership on its own. If combined, existing initiatives could provide a comprehensive and inclusive approach that would target all entry points and include key stakeholders such as household decision-makers, MHO elected members, healthcare professionals, community leaders, governmental authorities, medical advisors, and promoters. There is a need to evaluate empirically the implementation of these interventions. Mechanisms to promote dialogue between MHO stakeholders would be useful to devise innovative strategies, avoid repeating unsuccessful ones, and develop a coordinated plan to promote MHOs.

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Section: Introductionmentioning

confidence: 99%

Mapping of initiatives to increase membership in mutual health organizations in Benin

Turcotte-Tremblay

Haddad

Yacoubou³

et al. 2012

International Journal for Equity in Health

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“…Other studies confirm that poor people are less likely to enrol in a CHI, coining the term “exclusion effect” to describe the phenomenon [26–28]. Since the majority of the TCHP members pay their premium via their milk account, it was interesting to know if the respondents were able to supply their milk continuously throughout the year.…”

Section: Discussionmentioning

confidence: 99%

A quantitative study on factors influencing enrolment of dairy farmers in a community health insurance scheme

Greef

Monareng

Roos

2016

BMC Health Serv Res

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BackgroundAccess to affordable and effective health care is a challenge in low- and middle- income countries. Out-of-pocket expenditure for health care is a major cause of impoverishment. One way to facilitate access and overcome catastrophic expenditure is through a health insurance mechanism, whereby risks are shared and financial inputs pooled by way of contributions. This study examined factors that influenced the enrolment status of dairy farmers in Western Kenya to a community health insurance (CHI) scheme.MethodsQuantitative, cross-sectional research was used to describe factors influencing the enrolment in the CHI scheme. Quota and convenience sampling was used, recruiting a sample of 135 farmers who supply milk to a dairy cooperation. Data were collected using a structured interview schedule and analysed using Stata SE, Data Analysis and Statistical Software, Version 12.ResultsFactors influencing non-enrolment were identified as affordability (40%; n = 47), unfamiliarity with the management of the scheme (37%; n = 44) and a lack of understanding about the scheme (41%; n = 48). An exploratory factor analysis was used to reduce the variables to two factors: information provision and understanding community health insurance (CHI). Logistic regression identified factors associated with enrolment in the Tanykina Community Healthcare Plan (TCHP). Supplies of less than six litres of milk per day (OR: 0.22; 95% CI: 0.06–0.84) and information provision (OR: 8.77; 95% CI: 2.25–34.16) were significantly associated with enrolment in the TCHP.Nearly 30% (29.6%; n = 40) of the respondents remarked that TCHP is expensive and 17% (n = 23) asked for more education on CHI and TCHP in an open-ended question.ConclusionRecommendations related to marketing strategies, financial approach, information provision and further research were outlined to be made to the management of the TCHP as well as to those involved in public health.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-016-1925-1) contains supplementary material, which is available to authorized users.

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“…All studies were conducted in Nigeria. Of these, two studies were conducted in communities in Northern Nigeria, [20,27] six in communities in south eastern Nigeria, [28][29][30][31][32][33] and one study in south western Nigeria. [34] Overall, the findings reveal a fairly satisfactory impact of health insurance in strengthening health system and improving primary health care delivery in the country.…”

Section: Study Settingsmentioning

confidence: 99%

“…Although, the authors made attempts to include interventional studies, it was not possible due to unavailability despite rigorous search methods applied. Of the nine studies included, six were cross-sectional [20,[27][28][29][30][31] with one using an exploratory method. [30] Also included in the review was a comparative case approach study, [33] a review/appraisal [33] and an ex-planatory survey.…”

Section: Study Designs and Outcomesmentioning

confidence: 99%

Healthcare financing in Nigeria: A systematic review assessing the evidence of the impact of health insurance on primary health care delivery

John

P.G

et al. 2014

JHA

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Strengthening health systems, improving health outcomes, as well as finding answers to the competing alternatives of healthcare financing are critical issues that continue to bother health policy makers. Irrespective of the options, the choice of health care financing should mobilize resources for health and improve access to quality care at the same time. Notably, the health financing policy in Nigeria provides a framework for establishing health insurance schemes so as to expand coverage in health care delivery for the formal and informal sectors as a strategy towards universal access to healthcare. Accordingly, the authors, through this review, systematically assess the evidence of the extent to which health insurance impacts on access to services and quality of primary healthcare in Nigeria. While this comes to bear, the findings reveal an evidence of moderate-to-high strength that health insurance increases access to care and improves the quality of care received; however, it remains equivocal in some instances. The review therefore contributes to the literature on healthcare financing by extending and qualifying existing knowledge and advocating for accelerated reforms if universal coverage will be achieved.

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Preferences for benefit packages for community-based health insurance: an exploratory study in Nigeria

Cited by 49 publications

References 8 publications

Mapping of initiatives to increase membership in mutual health organizations in Benin

Mapping of initiatives to increase membership in mutual health organizations in Benin

A quantitative study on factors influencing enrolment of dairy farmers in a community health insurance scheme

Healthcare financing in Nigeria: A systematic review assessing the evidence of the impact of health insurance on primary health care delivery

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