scholarly journals Feasibility and Desirability of Scaling up Community –based Health Insurance (CBHI) in rural communities in Uganda. Lessons from Kisiizi hospital CBHI scheme.

2019 ◽  
Author(s):  
ALEX KAKAMA AYEBAZIBWE
Keyword(s):  
Health Insurance ◽  
Health Financing ◽  
Scaling Up ◽  
Healthcare Services ◽  
Community Based ◽  
Leadership And Management ◽  
Community Based Health Insurance ◽  
Community Associations ◽  
Key Informant

Abstract Background Community-based health Insurance (CBHI) schemes have been implemented world over as initial steps for National Health Insurance. The CBHI concept developed out of a need for financial protection against catastrophic health expenditure to the poor after failure of other health financing mechanisms. CBHI schemes reduce out-of-pocket payments, and improve access to healthcare services in addition to raising additional revenue for health sector. Kisiizi hospital CBHI scheme has 41,500 registered members since 1996, organised in 210 community associations known as ‘Bataka’ or ‘Engozi’ societies. Members pay annual premium fees and a co-payment fee before service utilisation. This Study aimed at exploring the feasibility and desirability of scaling up CBHI in Rubabo County, with objectives of; exploring community perceptions and determining acceptability of CBHI, identifying barriers and enablers to scaling up CBHI and documenting lessons regarding CBHI expansion in a rural community. Method: Explorative study using qualitative methods. Key informant interviews and Focus Group Discussions (FGD) were used in data collection. Twenty two key informant interviews were conducted using semi-structured questionnaires. Three FGD for scheme members and three for non-scheme members were conducted. Data was analysed using thematic approach. Results : Scaling up Kisiizi hospital CBHI is desirable because: it conforms to the government social protection agenda, conforms to society values, offers a comprehensive benefits package, and is a better healthcare financing alternative for many households. Scaling up Kisiizi hospital CBHI is largely feasible because of a strong network of community associations, trusted quality of services at Kisiizi Hospital, affordable insurance fees, and trusted leadership and management systems. Scheme expansion faces a few obstacles: long distances and high transport costs to Kisiizi hospital, low levels of knowledge about insurance, overlapping financial priorities at household level and inability of some households to pay insurance fees. Conclusions CBHI implementation requires the following considerations: Conformity with society values and government priorities, a comprehensive benefits package, trusted quality of healthcare services, affordable fees, and trusted leadership and management systems. Key words Community-based Health Insurance, Universal Health Coverage, Health financing, Enrolment

scholarly journals Feasibility and Desirability of Scaling up Community –based Health Insurance (CBHI) in rural communities in Uganda. Lessons from Kisiizi hospital CBHI scheme.

2019 ◽  
Author(s):  
ALEX KAKAMA AYEBAZIBW
Keyword(s):  
Health Insurance ◽  
Scaling Up ◽  
Management Systems ◽  
Community Based ◽  
Leadership And Management ◽  
Community Based Health Insurance ◽  
Community Associations ◽  
Key Informant ◽  
Benefits Package

Abstract Abstract Background Community-based health Insurance (CBHI) schemes have promoted equitable healthcare access and raised additional revenue for health sector, in addition to forming foundations for National Health Insurance schemes in many countries. Non-profit making organisations characterised by solidarity, voluntary membership and prepayment for health care. Kisiizi hospital CBHI scheme has 41,500 registered members since 1996, organised in 210 community associations known as ‘Bataka’ or ‘Engozi’ societies. Members pay annual premium fees and a co-payment fee before service utilisation. This Study aimed at exploring the feasibility and desirability of scaling up CBHI in Rubabo County, with objectives of; exploring community perceptions and determining acceptability of CBHI, identifying barriers and enablers to scaling up CBHI and documenting lessons regarding CBHI expansion in a rural community. Method: Descriptive study using qualitative methods. Key informant interviews and Focus Group Discussions (FGD) were used in data collection. Participants were selected from three villages with differing levels of insurance coverage. Twenty two key informant interviews were conducted using semi-structured questionnaires. Three FGD for scheme members and three for non-scheme members were conducted. Data was analysed using thematic approach. Results: Scaling up Kisiizi hospital CBHI is desirable because; it conforms to the national social protection agenda, conforms to society values, offers a comprehensive benefits package, and is a better healthcare financing alternative for many households. Secondly, scaling up Kisiizi hospital CBHI is largely feasible since a strong network of community associations exist, trusted quality of services at Kisiizi Hospital, affordable fees, and trusted leadership and management systems. However, scale up of the Kisiizi hospital CBHI is still limited by; long distances and high transport costs to Kisiizi hospital, low levels of knowledge about insurance, overlapping financial priorities at household level and inability of some households to pay insurance fees. Conclusions CBHI scheme implementation requires the following considerations; Conformity with local society values, conformity with national policies/guidelines, a comprehensive benefits package, trusted quality of healthcare services, affordable fees, and trusted leadership and management systems. Key words Community-based Health Insurance, Universal Health Coverage, Health financing, Enrolment

scholarly journals Barriers and facilitators of community based health insurance membership in rural Amhara region, northwest Ethiopia: A qualitative study

2019 ◽  
Author(s):  
Getu Debalkie Demissie ◽  
Asmamaw Atnafu
Keyword(s):  
Health Insurance ◽  
Health Financing ◽  
Northwest Ethiopia ◽  
Amhara Region ◽  
Community Based ◽  
Main Research ◽  
Low Level ◽  
Community Based Health Insurance ◽  
Out Of Pocket Payments ◽  
Key Informant

Abstract Background: More than 150 million people encounter huge cost of health expenses every year, and most of these treatment seekers face poverty owing to out of pocket payments. Community-based health insurance won popularity as a makeshift health financing mechanism for out of pocket payments in poor communities. The aim of this study was to identify the facilitators and impediments of enrollment to community based health insurance in rural parts of the Amhara region, Ethiopia.Method: Focus group discussions (FGD) were the main research methodology supplemented by key informant interviews (KII). The FGD participants were selected by purposive sampling techniques based on the membership status of CBHI (members or non-members). Six FGDs and four key informant interviewees were conducted in March 2018 in three districts. Before analyzing the data, all FGDs and KIIs were transcribed and transferred into Atlasti version 7.1 software. Thematic analysis was done according to key themes arising from the data. Results: Low level of awareness, perception of high amount of premium, poor perception of quality of services and lack of trust in community based health insurance are the barriers to membership in community based health insurance.Conclusion: There has been a low level of awareness and misconception about community based health insurance. The major reason for not joining CBHI was incapacity to pay the premium.

scholarly journals The Effect of Ethiopia’s Community-Based Health Insurance Scheme on Revenues and Quality of Care

2020 ◽  
Vol 17 (22) ◽  
pp. 8558
Author(s):  
Zemzem Shigute ◽  
Anagaw D. Mebratie ◽  
Robert Sparrow ◽  
Getnet Alemu ◽  
Arjun S. Bedi
Keyword(s):  
Health Care ◽  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Insurance ◽  
Access To Health Care ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Community Based Health Insurance ◽  
The Impact

Ethiopia’s Community-Based Health Insurance (CBHI) scheme was established with the objectives of enhancing access to health care, reducing out-of-pocket expenditure (OOP), mobilizing financial resources and enhancing the quality of health care. Previous analyses have shown that the scheme has enhanced health care access and led to reductions in OOP. This paper examines the impact of the scheme on health facility revenues and quality of care. This paper relies on a difference-in-differences approach applied to both panel and cross-section data. We find that CBHI-affiliated facilities experience a 111% increase in annual outpatient visits and annual revenues increase by 47%. Increased revenues are used to ameliorate drug shortages. These increases have translated into enhanced patient satisfaction. Patient satisfaction increased by 11 percentage points. Despite the increase in patient volume, there is no discernible increase in waiting time to see medical professionals. These results and the relatively high levels of CBHI enrollment suggest that the Ethiopian CBHI has been able to successfully negotiate the main stumbling block—that is, the poor quality of care—which has plagued similar CBHI schemes in Sub-Saharan Africa.

Feasibility and quality of cardiovascular disease prevention within a community-based health insurance program in rural Nigeria

2015 ◽  
Vol 33 (2) ◽  
pp. 366-375 ◽  
Author(s):  
Marleen E. Hendriks ◽  
Oladimeji A. Bolarinwa ◽  
Ferdinand W.N.W. Wit ◽  
Lizzy M. Brewster ◽  
Aina O. Odusola ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Health Insurance ◽  
Disease Prevention ◽  
Cardiovascular Disease Prevention ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Insurance Program ◽  
Health Insurance Program ◽  
Rural Nigeria
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