Impact of community-based health insurance and economic status on utilization of healthcare services: A household-level cross-sectional survey from rural central India

2020 ◽  
Vol 33 (2) ◽  
pp. 74
Author(s):  
Rajnish Joshi ◽  
Abhijit Pakhare ◽  
Sameer Yelwatkar ◽  
Anant Bhan ◽  
SP Kalantri ◽  
...  
Keyword(s):  
Health Insurance ◽  
Economic Status ◽  
Central India ◽  
Healthcare Services ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Household Level ◽  
Community Based Health Insurance ◽  
Utilization Of Healthcare

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 Nutritional status of adolescent girls in Bangladesh: findings of a community based survey

2016 ◽  
Vol 6 (1) ◽  
pp. 3-7 ◽  
Author(s):  
Kabir Hossen ◽  
Fazlur Rahman ◽  
Saidur Rahman Mashreky
Keyword(s):  
Nutritional Status ◽  
Adolescent Girls ◽  
Large Population ◽  
Population Data ◽  
Health Care Facilities ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Household Level ◽  
Under Nutrition

Poverty, large population, socio- economic inequalities and inadequate access to proper health care facilities are the key causes of under nutrition in Bangladesh. Adolescents are the most vulnerable group for under nutrition and having great consequence as they will be parent in future. Studies on nutritional status of adolescent girls are fewer in number and have great effect for intervention. The objective of this study was to assess the nutritional status and predisposing factors of under nutrition among the adolescent girls in Bangladesh. A community-based cross-sectional survey was carried out from July to December 2013. Adolescent girls were the study population. Data was collected by face to face interview at household level. According to BMI category (kg/m2) the prevalence of under-weight (BMI<18.5) was found 65.9% and as per Gomez Classification (Weight for age), the prevalence of malnutrition was 48.2% (mild), 23.5% (moderate) and 2.8% (severe) categories and finally, as per Water Low Classification wasting found 16.6% (mild), 3.5%(moderate) and 0.2% severe categories. On the other hand, stunting found 39.6 % (mild), 9.2% (moderate) and 2.3% (severe) categories. Prevalence of under nutrition was found much higher (82.3%) among younger age group (?12 years). Higher prevalence of under-nutrition also found among the functionally illiterate adolescent girls, it was 75.8% and 51.3% among illiterate and literate group respectively. In both of the cases difference was statistically significant (p<0.001). The prevalence of illness found higher among under-weight adolescent girls in last two weeks compare to healthy adolescent girls both in rural and urban settings. This difference also found statistically significant (p<0.001). Under nourishment found higher among younger and low literate girls. Prevalence of other symptoms is also found higher among them.South East Asia Journal of Public Health Vol.6(1) 2016: 3-7

scholarly journals Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?

2009 ◽  
Vol 25 (2) ◽  
pp. 155-161 ◽  
Author(s):  
O. Onwujekwe ◽  
E. Okereke ◽  
C. Onoka ◽  
B. Uzochukwu ◽  
J. Kirigia ◽  
...  
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Economic Status ◽  
Place Of Residence ◽  
Community Based ◽  
Community Based Health Insurance

scholarly journals The path to UHC: The Lessons learnt from transitioning from a Community-based to a State-wide health insurance Scheme in Nigeria.

2020 ◽  
Author(s):  
Oladimeji Akeem Bolarinwa ◽  
Tanimola Makanjuola Akande ◽  
Wendy Janssens ◽  
Kwasi Boahene ◽  
Tobias Rinke de Wit
Keyword(s):  
Health Insurance ◽  
Transition Period ◽  
Healthcare Services ◽  
Coping Mechanisms ◽  
Health Insurance Scheme ◽  
Insurance Scheme ◽  
Cross Sectional Survey ◽  
Community Based ◽  
Insurance Program ◽  
Personal Savings

Abstract Background Social health insurance has been widely proposed as a key strategy in moving towards universal health coverage. This paper reports on the transition of a community-based health insurance scheme in Kwara State, Nigeria, in 2016 to a state-wide social insurance program. Specifically, it analyses the consequences of the temporary suspension of the community-based insurance scheme during the transition period on healthcare utilization and financial protection.Methods A mixed methods study was carried out in 2018 using a semi-quantitative cross-sectional survey amongst 600 clients, in-depth interviews with 24 clients and 29 participating public and private healthcare providers.Results Most former enrollees (95.3%) kept using Kwara Community Health Insurance Program (KCHIP) facilities, even after the suspension of the program. Over 70% of respondents reverted to out-of-pocket (OOP) payment for healthcare services and 67% experienced constraints in payment for healthcare services after suspension of the program. Most common coping mechanisms for healthcare payment was personal savings (63.3%). Seventeen of 29 facilities recorded a decrease in revenue after suspension of the program. Being male (OR=1.61), respondents living in rural communities (OR=1.77), those who use KCHIP exclusively (OR=1.94) and acutely ill respondents (OR=3.38) had increased odds of being constrained with the suspension of the program.Conclusion After suspension of the KCHIP, many enrollees and health facilities experienced constraints. Enrollees’ most important coping mechanisms remained personal savings which has more likelihood of pushing them to catastrophic expenditure.

scholarly journals Willingness of community based health insurance uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alem Deksisa ◽  
Meyrema Abdo ◽  
Ebrahim Mohamed ◽  
Daniel Tolesa ◽  
Sileshi Garoma ◽  
...  
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Urban Residents ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Regional State

Abstract Background Globally, Millions of people cannot use health services because of the fear of payment for the service at the time of service delivery. From the agenda of transformation and the current situation of urbanization as well as to ensure universal health coverage implementing this program to the urban resident is mandatory. The aim of this study is to assess the willingness of community-based health insurance (CBHI) uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, 2018. Methods A community-based cross-sectional study was conducted. From the total of eighteen towns; six towns which account for 33% of the total were selected randomly for the study. One population proportion formula was employed to get a total of 845 households. A pre-tested, semi-structured interviewer-administered questionnaire was used to collect the required data. Double-Bounded Dichotomous Choice Variant of the contingent valuation method was used to assess the maximum willingness to pay for the scheme, and a multiple logistic regression model was used to determine the effect of various factors on the willingness to join and willingness to pay for the households. Result About 839 (99.3%) of the respondents participated. The mean ages of the respondents were 40.44(SD ± 11.12) years. 621 (74.1%) ever heard about CBHI with 473 (56.3%) knowing the benefits package. Out of 839, 724 (86.3%) were willing to uptake CBHI of which 704 (83.9%) were willing to pay if CBHI established in their town. Conclusion If CBHI established about 86.3% of the households would enroll in the scheme. Having education, with a family size between 3 & 6, having difficulty in paying for health care and less than 20mins it took to reach the nearest health facility were the independent predictors of the willingness of CBHI uptake. The Oromia and Towns Health Bureau should consider the availability of health facilities near to the community and establishing CBHI in the urban towns.

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