Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda
This paper evaluates the impact of prepayment schemes on access to health care for poor households, based on household survey data. Rwanda is one of the poorest countries in the world. After the genocide in 1994, public health care services were pr...
Main Authors: | , |
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Format: | Working Paper |
Language: | English en_US |
Published: |
World Bank, Washington, DC
2013
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Subjects: | |
Online Access: | http://documents.worldbank.org/curated/en/2001/09/3916689/synopsis-results-impact-community-based-health-insurance-financial-accessibility-health-care-rwanda http://hdl.handle.net/10986/13798 |
Summary: | This paper evaluates the impact of
prepayment schemes on access to health care for poor
households, based on household survey data. Rwanda is one of
the poorest countries in the world. After the genocide in
1994, public health care services were provided for free to
patients, financed by donors and the government. In 1996,
the Ministry of Health reintroduced prewar level user
charges. By 1999, utilization of primary health care
services had dropped from 0.3 in 1997 to a national average
of 0.2 annual consultations per capita. This sharp drop in
health service use combined with growing concerns about
rising poverty, poor health outcome indicators, and a
worrisome HIV prevalence among all population groups
motivated the Rwandan government to develop community-based
health insurance to assure access to the modern health
system for the poor. The findings presented in this paper
reveal that insurance enrollment is determined by household
characteristics such as the health district of household
residence, education level of household head, family size,
distance to the health facility, and radio ownership,
whereas health and economic indicators did not influence
enrollment. Insurance members report up to five times higher
health service use than nonmembers. |
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