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 t...
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| Format: | Working Paper |
| Language: | English en_US |
| Published: |
World Bank, Washington, DC
2013
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| Online Access: | http://documents.worldbank.org/curated/en/2001/09/3546014/impact-health-insurance-access-health-care-financial-protection-rural-developing-countries-example-senegal http://hdl.handle.net/10986/13774 |
| Summary: | 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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