The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal
Community-based health insurance schemes are becoming increasingly recognized as an instrument to finance health care in developing countries. Taking the example of "les mutuelles de santes" (mutual health organization) in rural Senegal this paper analyzes whether or not members in a mutual health insurance scheme have better access to health care than nonmembers. A binary probit model is estimated for the determinants of participation in a mutual and a logit/log linear model is used to measure the impact on health care utilization and financial protection. The results show that, while the health insurance schemes reach otherwise excluded people, the very poorest in the communities are not covered. Regarding the impact on the access to health care, members have a higher probability of using hospitalization services than nonmembers and pay substantially less when they need care. Given the results of this study, community financing schemes have the potential to improve the risk-management capacity of rural households. To reduce identified limitations of the schemes, an enlargement of the risk pool and a scaling up or linking of the schemes is, however, a prerequisite. Appropriate instruments to be further tested should include reinsurance policies, subsidies for the poorest and developing linkages to the private sector via the promotion of group insurance policies. All these instruments call for a stronger role of public health policy.
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dig-okr-10986137742024-08-08T17:35:54Z The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal Jutting, Johannes Paul ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS Community-based health insurance schemes are becoming increasingly recognized as an instrument to finance health care in developing countries. Taking the example of "les mutuelles de santes" (mutual health organization) in rural Senegal this paper analyzes whether or not members in a mutual health insurance scheme have better access to health care than nonmembers. A binary probit model is estimated for the determinants of participation in a mutual and a logit/log linear model is used to measure the impact on health care utilization and financial protection. The results show that, while the health insurance schemes reach otherwise excluded people, the very poorest in the communities are not covered. Regarding the impact on the access to health care, members have a higher probability of using hospitalization services than nonmembers and pay substantially less when they need care. Given the results of this study, community financing schemes have the potential to improve the risk-management capacity of rural households. To reduce identified limitations of the schemes, an enlargement of the risk pool and a scaling up or linking of the schemes is, however, a prerequisite. Appropriate instruments to be further tested should include reinsurance policies, subsidies for the poorest and developing linkages to the private sector via the promotion of group insurance policies. All these instruments call for a stronger role of public health policy. 2013-06-05T15:31:45Z 2013-06-05T15:31:45Z 2001-09 http://documents.worldbank.org/curated/en/2001/09/3546014/impact-health-insurance-access-health-care-financial-protection-rural-developing-countries-example-senegal 1-932126-06-6 https://hdl.handle.net/10986/13774 English en_US HNP discussion paper series; CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo/ World Bank application/pdf text/plain World Bank, Washington, DC |
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Banco Mundial |
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Estados Unidos |
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US |
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Bibliográfico |
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En linea |
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dig-okr |
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biblioteca |
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America del Norte |
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Biblioteca del Banco Mundial |
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English en_US |
| topic |
ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS |
| spellingShingle |
ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS Jutting, Johannes Paul The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| description |
Community-based health insurance schemes
are becoming increasingly recognized as an instrument to
finance health care in developing countries. Taking the
example of "les mutuelles de santes" (mutual
health organization) in rural Senegal this paper analyzes
whether or not members in a mutual health insurance scheme
have better access to health care than nonmembers. A binary
probit model is estimated for the determinants of
participation in a mutual and a logit/log linear model is
used to measure the impact on health care utilization and
financial protection. The results show that, while the
health insurance schemes reach otherwise excluded people,
the very poorest in the communities are not covered.
Regarding the impact on the access to health care, members
have a higher probability of using hospitalization services
than nonmembers and pay substantially less when they need
care. Given the results of this study, community financing
schemes have the potential to improve the risk-management
capacity of rural households. To reduce identified
limitations of the schemes, an enlargement of the risk pool
and a scaling up or linking of the schemes is, however, a
prerequisite. Appropriate instruments to be further tested
should include reinsurance policies, subsidies for the
poorest and developing linkages to the private sector via
the promotion of group insurance policies. All these
instruments call for a stronger role of public health policy. |
| topic_facet |
ADVERSE SELECTION ADVERSE SELECTION PROBLEMS COMMUNITIES COMMUNITY PARTICIPATION DECENTRALIZATION ECONOMIC DEVELOPMENT ECONOMICS EMPLOYMENT EXPENDITURES GENDER HEALTH CARE HEALTH CARE COSTS HEALTH CARE FINANCING HEALTH CARE PROVIDERS HEALTH CARE PROVISION HEALTH CARE SERVICES HEALTH CARE UTILIZATION HEALTH FINANCING HEALTH INSURANCE HEALTH POLICY HEALTH SECTOR HEALTH SERVICES HEALTH STATUS HEALTH SYSTEMS HOSPITALIZATION HOSPITALS HOUSEHOLDS INCOME INFORMAL SECTOR INHABITANTS INNOVATION INPATIENT CARE INTERVENTION ISOLATION LOW-INCOME COUNTRIES MUTUAL AID NUTRITION PARENTS PRIMARY HEALTH CARE PRIVATE SECTOR PROBABILITY PUBLIC HEALTH PUBLIC SECTOR RURAL AREAS RURAL HOUSEHOLDS SELECTION BIAS SURGERY SUSTAINABILITY VILLAGES WORKERS |
| author |
Jutting, Johannes Paul |
| author_facet |
Jutting, Johannes Paul |
| author_sort |
Jutting, Johannes Paul |
| title |
The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| title_short |
The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| title_full |
The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| title_fullStr |
The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| title_full_unstemmed |
The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal |
| title_sort |
impact of health insurance on the access to health care and financial protection in rural developing countries : the example of senegal |
| publisher |
World Bank, Washington, DC |
| publishDate |
2001-09 |
| url |
http://documents.worldbank.org/curated/en/2001/09/3546014/impact-health-insurance-access-health-care-financial-protection-rural-developing-countries-example-senegal https://hdl.handle.net/10986/13774 |
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