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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Main Author:	Jutting, Johannes Paul
Format:	Working Paper
Language:	English en_US
Published:	World Bank, Washington, DC 2013
Subjects:	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
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

id	okr-10986-13774
recordtype	oai_dc
spelling	okr-10986-137742021-04-23T14:03:10Z 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 http://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 World Bank, Washington, DC Publications & Research :: Working Paper Publications & Research Africa Senegal
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	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
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 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
geographic_facet	Africa Senegal
relation	HNP discussion paper series;
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.
format	Publications & Research :: Working Paper
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	2013
url	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
_version_	1764424596318060544

The Impact of Health Insurance on the Access to Health Care and Financial Protection in Rural Developing Countries : The Example of Senegal

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