Evaluating the Impact and Effectiveness of Community-Based Health Insurance Policy Among Informal Sector in Lagos State Using Donabedian Model

The study used the Donabedian model (process, structure, and outcome) to evaluate the impact and effectiveness of the Community Based Health Insurance Scheme (CBHIS) among informal sector population in rural and semi-urban areas of Lagos State, and the respondents were drawn among the market men and women, motorist, among others. Three hundred and eighty-four (384) respondents were sampled based on the research advisor's sampling size. Lagos State is stratified along with its three senatorial districts and a local government each is purposively selected based on the full implementation of CBHIS. Data were analysed using descriptive and interferential statistics and the result revealed that 55% of respondents attested to the effectiveness of CBHIS in drastically reducing the cost of medical services and enhancing equal accessibility for healthcare needs. On the other hand, the implementation of CBHIS has no significant impact on healthcare service delivery due to the unfriendly attitude of healthcare providers towards the beneficiaries. The study concluded by providing information on the outcomes of CBHIS implementation at the sub-national level of government in Nigeria and suggest ways of improvement.

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Community Based Health Insurance Scheme and State-Local Relations in Rural and Semi-Urban Areas of Lagos State, Nigeria

Public Organization Review ◽

10.1007/s11115-020-00474-5 ◽

2020 ◽

Author(s):

Afeez Kolawole Shittu ◽

Olugbemiga Samuel Afolabi

Keyword(s):

Health Insurance ◽

Urban Areas ◽

Health Insurance Scheme ◽

Insurance Scheme ◽

Community Based ◽

Community Based Health Insurance ◽

Lagos State

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The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda

SSRN Electronic Journal ◽

10.2139/ssrn.3367423 ◽

2019 ◽

Author(s):

Andinet Woldemichael ◽

Daniel Gurara ◽

Abebe Shimeles

Keyword(s):

Health Insurance ◽

Healthcare Spending ◽

Community Based ◽

Community Based Health Insurance ◽

The Impact

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

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17228558 ◽

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.

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The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization

International Journal of Health Services ◽

10.1177/0020731415595609 ◽

2015 ◽

Vol 47 (3) ◽

pp. 504-518 ◽

Cited By ~ 8

Author(s):

Somdeth Bodhisane ◽

Sathirakorn Pongpanich

Keyword(s):

Health Care ◽

Health Insurance ◽

Household Income ◽

Health Care Services ◽

Lower Probability ◽

Community Based ◽

Cross Sectional ◽

Community Based Health Insurance ◽

Care Services ◽

The Impact

The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

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