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Dropping out of Ethiopia's community-based health insurance scheme

Mebratie, Anagaw; Sparrow, Robert; Yilma, Zelalem; Alemu, Getnet; Bedi, Arjun

Description

Low contract renewal rates have been identified as one of the challenges facing the development of community-based health insurance (CBHI) schemes. This article uses longitudinal household survey data gathered in 2012 and 2013 to examine dropout in the case of Ethiopia's pilot CBHI scheme. We treat dropout as a function of scheme affordability, health status, scheme understanding and quality of care. The scheme saw enrolment increase from 41% 1 year after inception to 48% a year later. An...[Show more]

dc.contributor.authorMebratie, Anagaw
dc.contributor.authorSparrow, Robert
dc.contributor.authorYilma, Zelalem
dc.contributor.authorAlemu, Getnet
dc.contributor.authorBedi, Arjun
dc.date.accessioned2015-12-07T22:28:06Z
dc.identifier.issn0268-1080
dc.identifier.urihttp://hdl.handle.net/1885/22227
dc.description.abstractLow contract renewal rates have been identified as one of the challenges facing the development of community-based health insurance (CBHI) schemes. This article uses longitudinal household survey data gathered in 2012 and 2013 to examine dropout in the case of Ethiopia's pilot CBHI scheme. We treat dropout as a function of scheme affordability, health status, scheme understanding and quality of care. The scheme saw enrolment increase from 41% 1 year after inception to 48% a year later. An impressive 82% of those who enrolled in the first year renewed their subscriptions, while 25% who had not enrolled joined the scheme. The analysis shows that socioeconomic status, a greater understanding of health insurance and experience with and knowledge of the CBHI scheme are associated with lower dropout rates. While there are concerns about the quality of care and the treatment meted out to the insured by providers, the overall picture is that returns from the scheme are overwhelmingly positive. For the bulk of households, premiums do not seem to be onerous, basic understanding of health insurance is high and almost all those who are currently enrolled signalled their desire to renew contracts.
dc.publisherBritish Academy and Oxford University Press
dc.sourceHealth Policy and Planning
dc.titleDropping out of Ethiopia's community-based health insurance scheme
dc.typeJournal article
local.description.notesImported from ARIES
local.identifier.citationvolumeOnline Early Version
dc.date.issued2015
local.identifier.absfor111708 - Health and Community Services
local.identifier.ariespublicationu5651450xPUB20
local.type.statusPublished Version
local.contributor.affiliationMebratie, Anagaw, Erasmus University Rotterdam
local.contributor.affiliationSparrow, Robert, College of Asia and the Pacific, ANU
local.contributor.affiliationYilma, Zelalem, Erasmus University Rotterdam
local.contributor.affiliationAlemu, Getnet, Addis Ababa University
local.contributor.affiliationBedi, Arjun, Erasmus University
local.description.embargo2037-12-31
local.bibliographicCitation.issue2015
local.bibliographicCitation.startpage1
local.bibliographicCitation.lastpage11
local.identifier.doi10.1093/heapol/czu142
local.identifier.absseo920208 - Health Policy Evaluation
dc.date.updated2016-02-24T11:37:07Z
local.identifier.scopusID2-s2.0-84948442914
CollectionsANU Research Publications

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