Enrollment in Ethiopia's Community-Based Health Insurance Scheme. (October 2015)

• Record Type: Journal Article
• Authors: Mebratie, Anagaw D.; Sparrow, Robert; Yilma, Zelalem; Alemu, Getnet; Bedi, Arjun S.
• Is Part Of: World development. Volume 74(2015)
• Page Start: 58
• Page End: 76
• Publication Date: 2015-10
• Subjects: Community-Based Health Insurance -- adverse selection -- social exclusion Ethiopia -- Africa; Economic history -- 1990- -- Periodicals; Economic assistance -- Developing countries -- Periodicals; 330.9
• DOI: 10.1016/j.worlddev.2015.04.011
• Languages: English
• ISSNs: 0305-750X

Abstract

Highlights: CBHI enrollment in Ethiopia is analyzed using household and health facility data. In less than two years scheme uptake reached 45.5% of target households. CBHI uptake is pro-poor and influenced by quality of care but not by adverse selection. Almost all the insured intend to renew, a majority of the uninsured plan to enroll. Linking CBHI to existing social programs and government structures boosts uptake. Summary: In June 2011, the Ethiopian government launched a Community-Based Health Insurance scheme. By December 2012, enrollment reached 45.5%. This paper examines uptake. Socioeconomic status does not inhibit uptake and food-insecure households are more likely to enroll. Chronic diseases and self-assessed health status do not induce enrollment, while past expenditure does. A relative novelty is the identification of quality of care. Both the availability of equipment and waiting time to see medical professionals substantially influences enrollment. Focus-groups raise concerns about providers favoring uninsured households. Nevertheless, almost all insured households want to renew and majority of uninsured want to enroll.