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...
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| Format: | Working Paper |
| Language: | English en_US |
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World Bank, Washington, DC
2013
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| 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 |
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okr-10986-137982021-04-23T14:03:09Z Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda Schneider, Pia Diop, François ACCESSIBILITY AGRICULTURE AVERAGE AGE BASIC HEALTH CARE CAPITATION COMMUNITIES COMMUNITY PARTICIPATION DATA COLLECTION DATA SOURCES DEBT RELIEF DEPENDENT VARIABLE DEVELOPMENT NETWORK DISTRICTS DONOR COMMUNITY ECONOMIC CHARACTERISTICS ECONOMIC DEVELOPMENT EDUCATION LEVEL EXPENDITURE DATA FAMILIES FINANCES FINANCIAL CONTRIBUTION FINANCIAL SUSTAINABILITY FINANCING MECHANISMS GENDER HEALTH CENTER HEALTH CENTERS HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH REFORM HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH STATUS HEALTH SURVEY HEALTH SYSTEM HOSPITAL COSTS HOSPITAL SERVICES HOSPITALS HOUSEHOLD CHARACTERISTICS HOUSEHOLD EXPENDITURES HOUSEHOLD HEAD HOUSEHOLD QUESTIONNAIRE HOUSEHOLD SIZE HOUSEHOLD SURVEY HOUSEHOLDS HUMAN DEVELOPMENT IMPROVED ACCESS INCOME COUNTRIES INCOME POPULATIONS INFORMAL SECTOR ISOLATION LAWS LOCAL LEVEL MALARIA MANAGEMENT CAPACITY MANAGERS MORAL HAZARD NATIONAL AVERAGE NATIONAL POPULATION NUTRITION PARTNERSHIP PATIENTS PEDIATRICS POLICY MEASURES POLICY OPTIONS POOR BENEFIT POOR COMMUNITIES POOR COUNTRIES POOR HOUSEHOLDS POPULATION GROUPS POVERTY ALLEVIATION PREGNANCY PRIMARY HEALTH CARE PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC POLICY PUBLIC SECTOR RADIO REGRESSION MODELS RESOURCE ALLOCATION SAMPLE HOUSEHOLDS SAMPLE SIZE SAMPLING FRAME SOCIAL PROTECTION SUSTAINABILITY TECHNICAL ASSISTANCE TECHNICAL SUPPORT WORKERS 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. 2013-06-05T19:08:55Z 2013-06-05T19:08:55Z 2001-09 http://documents.worldbank.org/curated/en/2001/09/3916689/synopsis-results-impact-community-based-health-insurance-financial-accessibility-health-care-rwanda 1-932126-08-2 http://hdl.handle.net/10986/13798 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 Rwanda |
| 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 |
ACCESSIBILITY AGRICULTURE AVERAGE AGE BASIC HEALTH CARE CAPITATION COMMUNITIES COMMUNITY PARTICIPATION DATA COLLECTION DATA SOURCES DEBT RELIEF DEPENDENT VARIABLE DEVELOPMENT NETWORK DISTRICTS DONOR COMMUNITY ECONOMIC CHARACTERISTICS ECONOMIC DEVELOPMENT EDUCATION LEVEL EXPENDITURE DATA FAMILIES FINANCES FINANCIAL CONTRIBUTION FINANCIAL SUSTAINABILITY FINANCING MECHANISMS GENDER HEALTH CENTER HEALTH CENTERS HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH REFORM HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH STATUS HEALTH SURVEY HEALTH SYSTEM HOSPITAL COSTS HOSPITAL SERVICES HOSPITALS HOUSEHOLD CHARACTERISTICS HOUSEHOLD EXPENDITURES HOUSEHOLD HEAD HOUSEHOLD QUESTIONNAIRE HOUSEHOLD SIZE HOUSEHOLD SURVEY HOUSEHOLDS HUMAN DEVELOPMENT IMPROVED ACCESS INCOME COUNTRIES INCOME POPULATIONS INFORMAL SECTOR ISOLATION LAWS LOCAL LEVEL MALARIA MANAGEMENT CAPACITY MANAGERS MORAL HAZARD NATIONAL AVERAGE NATIONAL POPULATION NUTRITION PARTNERSHIP PATIENTS PEDIATRICS POLICY MEASURES POLICY OPTIONS POOR BENEFIT POOR COMMUNITIES POOR COUNTRIES POOR HOUSEHOLDS POPULATION GROUPS POVERTY ALLEVIATION PREGNANCY PRIMARY HEALTH CARE PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC POLICY PUBLIC SECTOR RADIO REGRESSION MODELS RESOURCE ALLOCATION SAMPLE HOUSEHOLDS SAMPLE SIZE SAMPLING FRAME SOCIAL PROTECTION SUSTAINABILITY TECHNICAL ASSISTANCE TECHNICAL SUPPORT WORKERS |
| spellingShingle |
ACCESSIBILITY AGRICULTURE AVERAGE AGE BASIC HEALTH CARE CAPITATION COMMUNITIES COMMUNITY PARTICIPATION DATA COLLECTION DATA SOURCES DEBT RELIEF DEPENDENT VARIABLE DEVELOPMENT NETWORK DISTRICTS DONOR COMMUNITY ECONOMIC CHARACTERISTICS ECONOMIC DEVELOPMENT EDUCATION LEVEL EXPENDITURE DATA FAMILIES FINANCES FINANCIAL CONTRIBUTION FINANCIAL SUSTAINABILITY FINANCING MECHANISMS GENDER HEALTH CENTER HEALTH CENTERS HEALTH EXPENDITURES HEALTH FACILITIES HEALTH FINANCING HEALTH INSURANCE HEALTH REFORM HEALTH SECTOR HEALTH SERVICE HEALTH SERVICES HEALTH STATUS HEALTH SURVEY HEALTH SYSTEM HOSPITAL COSTS HOSPITAL SERVICES HOSPITALS HOUSEHOLD CHARACTERISTICS HOUSEHOLD EXPENDITURES HOUSEHOLD HEAD HOUSEHOLD QUESTIONNAIRE HOUSEHOLD SIZE HOUSEHOLD SURVEY HOUSEHOLDS HUMAN DEVELOPMENT IMPROVED ACCESS INCOME COUNTRIES INCOME POPULATIONS INFORMAL SECTOR ISOLATION LAWS LOCAL LEVEL MALARIA MANAGEMENT CAPACITY MANAGERS MORAL HAZARD NATIONAL AVERAGE NATIONAL POPULATION NUTRITION PARTNERSHIP PATIENTS PEDIATRICS POLICY MEASURES POLICY OPTIONS POOR BENEFIT POOR COMMUNITIES POOR COUNTRIES POOR HOUSEHOLDS POPULATION GROUPS POVERTY ALLEVIATION PREGNANCY PRIMARY HEALTH CARE PROBABILITY PUBLIC HEALTH PUBLIC HEALTH CARE PUBLIC POLICY PUBLIC SECTOR RADIO REGRESSION MODELS RESOURCE ALLOCATION SAMPLE HOUSEHOLDS SAMPLE SIZE SAMPLING FRAME SOCIAL PROTECTION SUSTAINABILITY TECHNICAL ASSISTANCE TECHNICAL SUPPORT WORKERS Schneider, Pia Diop, François Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| geographic_facet |
Africa Rwanda |
| relation |
HNP discussion paper series; |
| description |
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. |
| format |
Publications & Research :: Working Paper |
| author |
Schneider, Pia Diop, François |
| author_facet |
Schneider, Pia Diop, François |
| author_sort |
Schneider, Pia |
| title |
Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| title_short |
Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| title_full |
Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| title_fullStr |
Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| title_full_unstemmed |
Synopsis of Results on the Impact of Community-Based Health Insurance on Financial Accessibility to Health Care in Rwanda |
| title_sort |
synopsis of results on the impact of community-based health insurance on financial accessibility to health care in rwanda |
| publisher |
World Bank, Washington, DC |
| publishDate |
2013 |
| url |
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 |
| _version_ |
1764424481676197888 |