Who benefits from the Obio Community Health Insurance Scheme in Rivers State, Nigeria? A benefit incidence analysis

Vaughan, Kelsey; Akwataghibe, Ngozi; Fakunle, Babatunde; Wolmarans, L

doi:10.1093/inthealth/ihw040

Cited by 3 publications

(3 citation statements)

References 16 publications

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“…This study reveals a disproportionate concentration of inpatient care benefits among richer individuals and demonstrates that the rich received a greater amount of benefits than did the poor, in agreement with prior studies [ 21 , 32 ]. In addition, we observed that this inequality among NRCMS enrollees was greater than that among URBMI participants, also in agreement with prior reports [ 33 , 34 ].…”

Section: Discussionsupporting

confidence: 91%

“…Divorced, single or separated individuals received significantly less reimbursements, indicating that marriage and family life are economically and spiritually positive factors in the effective utilization of available healthcare options. People with a higher education received more net benefits, in agreement with existing literature [ 32 ]. Higher education level is a marker of the ability to turn information into practical behaviors, resulting in a best use of healthcare.…”

Section: Discussionsupporting

confidence: 89%

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The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China

Yang

Chen

et al. 2018

Int J Equity Health

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BackgroundChina has recently made efforts to integrate urban and rural basic medical insurance systems in order to ensure both urban and rural enrollees obtain unified benefits. However, whether the distribution of government healthcare subsides has become more equitable remains unknown. The purpose of this study was to analyze determinants of and inequality in net inpatient care benefits under the integration of urban-rural medical insurance systems in China.MethodsData were obtained from a nationally representative household survey, the Fifth National Health Services Survey (2013), conducted in Anhui province. A multiple regression model and concentration index (CI) was used to estimate related factors and inequality of inpatient care net benefits.ResultsFindings indicated that individuals received more inpatient care benefits when urban and rural social healthcare systems were integrated. Factors associated with net benefits included gender, age, marital status, retirement, educational level, history of chronic diseases, health status, willingness to seek inpatient care and per capita income. The rich were found to disproportionately benefit from inpatient care, and the CI of net benefits for integrated insurance enrollees was the lowest among all three available health insurance schemes. These findings indicate that the recent unification of urban-rural social health insurances reduces inequality in net benefits from government subsidies. Some socioeconomic factors, such as per capita income, 60 years of age and over, history of chronic disease and high educational level positively influence inequality.ConclusionIn China, accelerating the integration of urban and rural medical insurance systems is an effective way to increase equity of benefit in urban and rural areas. Strategies aimed at reducing inpatient benefit inequality must address socioeconomic factors influencing healthcare outcomes.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 89%

The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China

Yang

Chen

et al. 2018

Int J Equity Health

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“…40 Some of these studies used concentration index and benefit analysis to provide stronger evidence of equity of utilisation. 43,[49][50][51][52][53] Two studies reported different findings; an insignificant difference in CBI scheme in Rwanda 45 and a study conducted in Tunisian found pro-poor distribution of benefits in both national and community-based health insurance schemes 51 .…”

Section: Place Of Residencementioning

confidence: 99%

Equity of national publicly funded health insurance schemes under the universal health coverage agenda: a systematic review of studies conducted in Africa

Anjorin

Ayorinde

Abba

et al. 2021

Journal of Public Health

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Background:The implementation of publicly funded health insurance schemes (PFHIS) is the major strategy to drive progress and achievement of universal health coverage (UHC) by 2030. We appraised evidence on the equity of insurance schemes across Africa.Methods: We conducted a systematic review of published studies that assessed equity in health insurance schemes implemented under the UHC agenda in Africa. Six databases, Web of Science, Medline, CINAHL, Scopus, Cochrane Library, EMBASE and World Bank eLibrary, were searched; we operationalised the PROGRESS-Plus equity framework to assess equity areas.Result: Forty-five studies met the inclusion criteria and were included in the study, in which 90% assessed equity by socioeconomic status. Evidence showed that rural residents, those selfemployed or working in the informal sector, men, those with lower educational attainment, and the poor were less likely covered by health insurance schemes. Broadly, the insurance schemes, especially, community-based health insurance (CBI) schemes improved utilisation by disadvantaged groups, however, the same groups were less likely to benefit from health services.Conclusion: Evidence on equity of PFHIS is mixed, however, CBI schemes seem to offer more equitable coverage and utilisation of essential health services in Africa

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Escaping from poverty trap: a choice between government transfer payments and public services

Chen¹,

Li²,

Lu³

et al. 2017

glob health res policy

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BackgroundAnti-poverty has always been an important issue to be settled. What policies should be selected to help individuals escaping from the poverty trap: by directly offering transfer payments or indirectly providing public services? This paper is among the first to explore the effects of public anti-poverty programs system in China.MethodsWe Using unbalanced panel data of China Health and Nutrition Survey (CHNS) from 1989 to 2009, we demonstrate how the individual poverty status is determined through a four-staged simultaneous model. We choose the 3SLS (Three Staged Linear Squared) methodology to do the estimation.ResultsGTPs (Government Transfer Payments) don’t have positive effects on poverty reductions. The results demonstrate that GTPs increasing by 10% makes private transfer payments decrease by 3.9%. Meanwhile, GTPs increasing by 10% makes the household income decreased by 27.1%. However, public services (such as medical insurance, health services, hygiene protection etc.) have significantly positive impacts on poverty reduction. Public services share a part of living cost of the poor, and are conducive for people to gain higher household income.ConclusionsGTPs given by governments are not effective in reducing the poverty, as a result of “crowd-out effect” and “inductive effect”. However, public services are suggested to be adopted by governments to help the poor out of the poverty trap.

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Who benefits from the Obio Community Health Insurance Scheme in Rivers State, Nigeria? A benefit incidence analysis

Abstract: Although the poor were found to benefit, this BIA revealed a tendency towards pro-rich distributions. Removing co-payments for the poorest, reducing long wait and visit times and using community volunteers to help increase access to health services may improve benefits for the poor.

Cited by 3 publications

References 16 publications

The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China

The inequality of inpatient care net benefit under integration of urban-rural medical insurance systems in China

Equity of national publicly funded health insurance schemes under the universal health coverage agenda: a systematic review of studies conducted in Africa

Escaping from poverty trap: a choice between government transfer payments and public services

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