Uptake of health insurance and the productive safety net program in rural Ethiopia

Abstract

Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. Terms of use: Documents in D I S C U S S I O N P A P E R S E R I E S Uptake of Health Insurance and the Productive Safety Net Program in Rural Ethiopia ABSTRACT Uptake of Health Insurance and the Productive Safety Net Program in Rural EthiopiaDue to lack of well-developed insurance, credit and labor markets, rural families in Ethiopia are exposed to a range of covariate and idiosyncratic risks. In 2005, to deal with the consequences of covariate risks, the government implemented the Productive Safety Net Program (PSNP) -an active labor market program to build rural assets, and in 2011, to mitigate the financial consequences of ill-health, the government introduced a pilot Community Based Health Insurance (CBHI) Scheme. This paper explores whether scheme uptake and retention is affected by access to the PSNP. Based on several rounds of household level panel data and qualitative information, the analysis shows that participating in the PSNP increases the probability of CBHI uptake by 24 percentage points and enhances scheme retention by 10 percentage points. Analysis of the channels through which the PSNP influences CBHI uptake indicates that the bulk of the effect may be attributed to explicit and implicit pressure applied by government officials on PSNP beneficiaries. Whether this is a desirable approach is debatable. Nevertheless, the results suggest that membership in existing social protection programs may be leveraged to spread new schemes and potentially accelerate poverty reduction efforts.JEL Classification: J65, J48, I13Keywords: productive safety net program, active labor market program, Ethiopia, community based health insurance, uptake of health insurance

Performance of an adapted household food insecurity access scale in measuring seasonality in household food insecurity in rural Ethiopia: a cohort analysis

“…As a subsample of the broader study, the current analysis included 473 households who were not taking part in the PSNP. We excluded households taking part in the programme [31,32]. As the programme member households get periodic cash support, their income basis would differ from households not taking part in the programme [31,33,34].…”

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

“…Ikub was positively related with the WTJ in [15,21,37], WTP for [42] and enrolment to [44,51,59] CBHI scheme. PSNP was a positive predictor to the uptake of [32], membership of [64], enrolment to [59], modern health care utilization related [65,66] CBHI. On the other hand, PSNP was also negatively related with CBHI utilization [20].…”

“…Households that were known to participate in local meetings were more willing to utilize CBHI than those households did not attend [20,48,49]. Households which were members in Iddir and Ikub [15,21,37,42,44,51,59] and PSNP [32,59,[64][65][66] were found to be more willing to uptake the scheme than those households that were not. But, participation in PSNP was also known to decrease the WTU the scheme [20].…”

“…Membership in Iddir and local credit association, i.e. Ikub (social capital, a traditional credit package)[15,21,37,42,44,51,59] and PSNP[32,59,[64][65][66] had positive relationship with CBHI utilization. Participation in Iddir and…”

Social Protection in an Aspiring 'Developmental State': The Political Drivers of Ethiopia's PSNP

“…For example, PSNP participation increased the probability of CBHI enrolment by 24 percentage points and reduced the probability of dropping out by 10 percentage points (Shigute et al 2016). Some kebele took the opportunity presented by distributing PSNP payments to provide information about CBHI and collect premiums, involuntarily in some cases (Shigute et al 2016). The EHIA evaluation notes that 14 percent of CBHI members in SNNPR and 4 percent across all the pilots were enrolled based on a deduction from their PSNP payments (EHIA 2015: 57).…”