Community‐Based Health Insurance scheme implementation in Ethiopia: A mini‐review on the experience and its implementation process

Abstract

The Community‐Based Health Insurance (CBHI) scheme was introduced in Ethiopia to overcome the population's over‐reliance on direct out‐of‐pocket expenditures for health care and the associated low level of health service utilization. CBHI is an advance payment arrangement, established on the household level, and targeted mainly at informal sectors in rural areas. After a successful 3‐year pilot implementation, the Ethiopian government decided to expand the CBHI scheme implementation. It has received wide interest among community members, especially those living with chronic diseases and perceived impaired family health status. Low enrollment to the scheme was the barrier to its initial expansion due to limited awareness and misconceptions about the program, financial constraints to paying premiums, and dissatisfaction with the health services. The evaluation of CBHI scheme implementation and future implications in Ethiopia could be better seen from both the learning experience during the implementation process and achievements of the policy objectives.