scholarly journals Scaling-up health insurance through community- based health insurance schemes in rural sub- Saharan African communities

2013 ◽  
Vol 3 (1) ◽  
pp. 14 ◽  
Author(s):  
Ufuoma John Ejughemre
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Rural Communities ◽  
Care Delivery ◽  
Sub Saharan Africa ◽  
Community Based ◽  
Seek Health Care ◽  
Community Based Health Insurance ◽  
The Poor ◽  
Sub Saharan

Context: The knotty and monumental problem of health inequality and the high burden of diseases in sub-Saharan Africa bothers on the poor state of health of many of its citizens particularly in rural communities. These issues are further exacerbated by the harrowing conditions of health care delivery and the poor financing of health services in many of these communities. Against these backdrops, health policy makers in the region are not just concerned with improving peoples’ health but with protecting them against the financial costs of illness. What is important is the need to support more robust strategies for healthcare financing in these communities in sub-Saharan Africa. Objective: This review assesses the evidence of the extent to which community-based health insurance (CBHI) is a more viable option for health care financing amongst other health insurance schemes in rural communities in sub-Saharan Africa. Patterns of health insurance in sub-Saharan Africa: Theoretically, the basis for health insurance is that it allows for risk pooling and therefore ensures that resources follow sick individuals to seek health care when needed. As it were, there are different models such as social, private and CBHI schemes which could come to bear in different settings in the region. However, not all insurance schemes will come to bear in rural settings in the region. Community based health insurance: CBHI is now recognized as a community-initiative that is community friendly and has a wide reach in the informal sector especially if well designed. Experience from Rwanda, parts of Nigeria and other settings in the region indicate high acceptability but the challenge is that these schemes are still very new in the region. Recommendations and conclusion: Governments and international development partners in the region should collect- ively develop CBHI as it will help in strengthening health systems and efforts geared towards achieving the millennium development goals. This is because it is inextricably linked to the health care needs of the poor. 

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.

scholarly journals Comparative Study of Enrollee Satisfaction with Private and Public Health Care Providers of Community Based Health Insurance Scheme in Edu LGA, Kwara State

2020 ◽  
pp. 77-84
Author(s):  
I. M. Sheshi ◽  
Y. F. Issa ◽  
S. A. Aderibigbe ◽  
B. E. Agbana ◽  
M. D. Sanni
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Care Delivery ◽  
Health Insurance Scheme ◽  
P Value ◽  
Insurance Scheme ◽  
Community Based ◽  
The Public ◽  
Private Providers ◽  
Community Based Health Insurance

Introduction: Many low and middle income countries keep on searching for different ways of financing their health systems. In order to ensure accessibility to quality health services by those in the rural areas, a Community Based Health Insurance Scheme was initiated which aim to integrate both human and financial resources within the rural communities to provide basic healthcare services to its resident.  In recent years, level of patient satisfactions have been identified as one of the major yardsticks to measure quality of healthcare. This study was conducted to compare enrollees satisfaction of public and private providers of community based health insurance scheme in Edu Local Government Area of Kwara State, Nigeria. Materials and Methodology: A descriptive cross sectional study was carried out among eight hundred respondents that were selected using multistage sampling technique. Data was collected using a semi-structured interviewer administered questionnaire and Focus Group Discussion. Analysis was done with EPI info software and confidence level was held at 95% and a p-value of less than 0.05 was considered as statistically significant. Results: The satisfaction level with private facility (4.28±0.35) was higher than that with public facilities (4.12 ±0.48). The difference was significant at a p-value of <0.001. Private providers had a higher satisfaction level than the public providers in the domains of empathy, tangibles, assurance and timeliness. The difference was statistically significant as the p-value was less than 0.05. No differences in level of satisfaction in responsiveness among the respondents of both providers as the p-value was 0.295. There was an association between marital status and satisfaction in public providers while an association occur between type of marriage and satisfaction in private provider. There was an association for both providers in occupation level, level of education and length of enrolment. Conclusion and Recommendation:  There was a higher overall satisfaction among enrollees of private providers than the public providers of Community Based Health Insurance Scheme. Health care delivery by private providers is of good quality and as such private facilities should be maintained as part of the providers of Community Based Health Insurance Scheme. Government should also strengthen monitoring and supervision to ensure good quality of health care delivery to the enrollees especially in the public health facilities.

scholarly journals COMMUNITY-BASED HEALTH INSURANCE SCHEME IN A RURAL COMMUNITY OF NORTH WEST NIGERIA: A ROADMAP TO ACHIEVING UNIVERSAL HEALTH COVERAGE.

2020 ◽  
Vol 14 (2) ◽  
pp. 125-130
Author(s):  
Lawal A ◽  
◽  
Gobir AA ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Insurance Scheme ◽  
Community Based ◽  
Quality Health Care ◽  
Community Based Health Insurance ◽  
Care Services

Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.

scholarly journals Effects of community-based health insurance on modern family planning utilization in Ethiopia

2019 ◽  
Vol 3 ◽  
pp. 1461
Author(s):  
Girma Kassie ◽  
Bekele Tefera
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Family Planning ◽  
Married Women ◽  
Reproductive Age ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Outcome Monitoring ◽  
Modern Family ◽  
Modern Family Planning

Background: Community-based health insurance (CBHI) has been established in a number of developing countries to expand access to modern health care service. However, few studies have focused on health care utilization of CBHI members in Ethiopia. Accordingly, the aim of this study was to assess the effect of CBHI on modern family planning (FP) utilization as part of its routine outcome monitoring activities. Methods: The USAID Transform: Primary Health Care project, conducted a continuous monitoring follow up visit using a multistage sampling technique in its four major targeted regions. A total of 3433 households were selected and 3313 women of reproductive age (15-49 years) were interviewed. The questionnaire captured the CBHI status of each household and FP use data from randomly selected women. Microsoft Access database was used to enter the data, which was then transferred to SPSS Version 20 for further analysis.  Results: In total 50.8% of married women (aged 15-49 years) were found to be enrolled in CBHI. Current modern FP use is 47.5% among married women in project-supported areas. Modern FP use is 50.9% among married women who are exposed to CBHI schemes, versus 44.1% among women who are not exposed to CBHI which is statistically significant.  Conclusions: Modern FP utilization among insured women was higher compared with uninsured women. While FP methods are provided for free, CBHI enrolment improves FP use among women of child-bearing age. Women who have access to CBHI may frequently visit health facilities seeking services for themselves and their families, during which they may be introduced to FP services. This in turn may improve their awareness and attitude towards FP. The results will increase awareness for program implementers of the benefits of CBHI schemes in FP programming, particularly in rural settings, and provide an opportunity to increase lifelong returns in Ethiopia.

scholarly journals HEALTH EDUCATION AND COMMUNITY MOBILIZATION IN NIGERIA - ISSUES AND PROSPECTS

2020 ◽  
Author(s):  
Ekpomebe Elozino ◽  
Leonard E. Ananomo ◽  
Andrew Abanum Onome Vivian
Keyword(s):  
Health Care ◽  
Health Education ◽  
Health Care Delivery ◽  
Care Delivery ◽  
National Development ◽  
International Health ◽  
Community Mobilization ◽  
Sub Saharan Africa ◽  
International Health Organizations ◽  
Sub Saharan

The significance of health to national development and poverty eradication over the centuries, in that improving health status and increasing life expectancy adds to long term economic growth. This article examined the condition of health education and community mobilization in Nigeria's health care delivery. Health literacy is imperative to power and sustains government efforts in fostering health for all. Many developing countries, particularly those in Sub-Saharan Africa, in the 1970s witnessed remarkable and improper inequalities in the provision and delivery of health services. This contributed to and explained the exploration of diverse approaches to enhance health care delivery by international health organizations.

scholarly journals Factors affecting the uptake of community-based health insurance in Ethiopia: a systematic review

2021 ◽  
Vol 7 (9) ◽  
pp. 459
Author(s):  
Ewunetie M. Bayked ◽  
Mesfin H. Kahissay ◽  
Birhanu D. Workneh
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Status ◽  
Health Service ◽  
Community Based ◽  
Factors Affecting ◽  
Health Care Coverage ◽  
Community Based Health Insurance ◽  
Universal Health Care Coverage ◽  
Universal Health

<p class="abstract">The goal of health care financing in Ethiopia is achieving universal health care coverage by community-based health insurance which was expected to cover more than eighty percent of the population. The aim was to minimize catastrophic out-of-pocket health service expenditure. We systematically reviewed factors affecting the uptake of community-based health insurance in Ethiopia. We searched various databases by 09 to 10 March 2019. We included articles regardless of their publication status with both quantitative and qualitative approaches.  The factors determining the uptake of community-based health insurance in Ethiopia were found to be demographic and socio-economic, and health status, and health service-related issues. Among demographic and socio-economic factors, the report of the studies regarding gender and age was not consistent. However, income, education, community participation, marriage, occupation, and family size were found to be significant predictors and were positively related to the uptake of the scheme.<strong> </strong>Concerning health status and health service-related factors; illness experience, benefit package, awareness level, previous out of pocket expenditure for health care service, and health service status (quality, adequacy, efficiency, and coverage) were significantly and positively related but the premium amount, self-rated health status and bureaucratic complexity were found to be negative predictors. To achieve universal health care coverage through community-based health insurance, special attention should be given to community-based intervention.</p>

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