Linking poverty-targeted social protection and Community Based Health Insurance in Ethiopia: Enrolment, linkages, and gaps

Mussa, Essa Chanie; Otchere, Frank; Vinci, Vincenzo; Reshad, Abduljelil; Palermo, Tia; Team, Isnp Evaluation

doi:10.1016/j.socscimed.2021.114312

Cited by 9 publications

(7 citation statements)

References 17 publications

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“…Respondents who were divorced and widowed were 0.35 times less likely to utilize CBHI health care services than married respondents. This result was supported by most other studies, 21,22,27 which revealed that married household heads were more likely to be CBHI users as compared to households heads with unmarried household heads. This could be explained by the fact that in Ethiopia, the payment policy for household membership contributions does not take married status into account.…”

Section: Discussionsupporting

confidence: 81%

Factors Associated With Community Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study

Moyehodie

Fenta

Mulugeta

et al. 2022

Health�Serv�Insights

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In Ethiopia, community-based health insurance was implemented to promote equitable access to sustainable quality health care and increase financial protection. The purpose of this study was to identify factors associated with community-based Health Insurance, Health Care Service Utilization of Households in the South Gondar Zone. A community-based cross-sectional study was employed. Data were collected among 619 randomly selected households in the south Gondar zone. Chi-square and binary logistic regression analyses with a P-Value of less than .05 were used to determine the association. Out of the total households, 511(82.6%) were using the CBHI scheme for health care service utilization. Residence, marital status, education level, occupation status, family size, presence of under-five children in the household, presence of elders in the households, nearest health institution, presence of chronic illness in the household’s, time taken to reach health institution, an attitude of a household were the determinant factors of community-based health insurance scheme health care service utilization of households. It is recommended that the local, regional and national governments, policymakers on optimal actions, NGOs, and other supporting organizations shall improve or scale-up the scheme by providing awareness to the community based on these significant factors and the attitude of households.

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Section: Discussionsupporting

confidence: 81%

Factors Associated With Community Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study

Moyehodie

Fenta

Mulugeta

et al. 2022

Health�Serv�Insights

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“…Merchants had easy access to media coverage, which helped them quickly understand CBHI benefits. Furthermore, compared to farmers, being a housewife ( Kado et al, 2020 ) increased likelihood of WTP; this is supported by a study that found female-headed households are more likely to enroll in and pay for CBHI than male-headed households ( Chu et al, 2019 , Mussa et al, 2021 ). In patriarchal societies for example Ethiopian, women were more responsible for their families' hygiene and health, and their nature made them more risk averters than males, making them more likely to pay for CBHI to protect against the unanticipated financial catastrophe of upcoming health expenses.…”

Section: Discussionmentioning

confidence: 90%

Multidimensional determinants of willingness to pay for community-based health insurance in Ethiopia and its implication towards universal health coverage: A narrative synthesis

Debalkie Atnafu,

Assefa Alemu

2023

Preventive Medicine Reports

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“…The efforts to integrate the social protection programmes also assume that increasing coverage of CBHI among PSNP-participating households will increase their health services utilisation and improve health outcomes. The ISNP was launched in 2019 [ 37 ].…”

Section: Methodsmentioning

confidence: 99%

Impact of community-based health insurance on health services utilisation among vulnerable households in Amhara region, Ethiopia

Mussa

Palermo

Ángeles

et al. 2023

BMC Health Serv Res

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Background Ethiopia piloted community-based health insurance in 2011, and as of 2019, the programme was operating in 770 districts nationwide, covering approximately 7 million households. Enrolment in participating districts reached 50%, holding promise to achieve the goal of Universal Health Coverage in the country. Despite the government’s efforts to expand community-based health insurance to all districts, evidence is lacking on how enrolment in the programme nudges health seeking behaviour among the most vulnerable rural households. This study aims to examine the effect of community-based health insurance enrolment among the most vulnerable and extremely poor households participating in Ethiopia’s Productive Safety Net Programme on the utilisation of healthcare services in the Amhara region. Methods Data for this study came from Amhara pilot integrated safety net programme baseline survey in Ethiopia and were collected between December 2018 and February 2019 from 5,398 households. We used propensity score matching method to estimate the impacts of enrolment in community-based health insurance on outpatient, maternal, and child preventive and curative healthcare services utilisation. Results Results show that membership in community-based health insurance increases the probabilities of visiting health facilities for curative care in the past month by 8.2 percentage points (95% CI 5.3 to 11.1), seeking care from a health professional by 8.4 percentage points (95% CI 5.5 to 11.3), and visiting a health facility to seek any medical assistance for illness and check-ups in the past 12 months by 13.9 percentage points (95% CI 10.5 to 17.4). Insurance also increases the annual household per capita health facility visits by 0.84 (95% CI 0.64 to 1.04). However, we find no significant effects of community-based health insurance membership on utilisation of maternal and child healthcare services. Conclusions Findings that community-based health insurance increased outpatient services utilisation implies that it could also contribute towards universal health coverage and health equity in rural and informal sectors. The absence of significant effects on maternal and child healthcare services may be due to the free availability of such services for everyone at the public health facilities, regardless of insurance membership. Outpatient services use among insured households is still not universal, and understanding of the barriers to use, including supply-side constraints, will help improve universal health coverage.

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Linking poverty-targeted social protection and Community Based Health Insurance in Ethiopia: Enrolment, linkages, and gaps

Cited by 9 publications

References 17 publications

Factors Associated With Community Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study

Factors Associated With Community Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study

Multidimensional determinants of willingness to pay for community-based health insurance in Ethiopia and its implication towards universal health coverage: A narrative synthesis

Impact of community-based health insurance on health services utilisation among vulnerable households in Amhara region, Ethiopia

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