Is community-based health insurance an equitable strategy for paying for healthcare? Experiences from southeast Nigeria


Onwujekwe, O; Onoka, C; Uzochukwu, B; Okoli, C; Obikeze, E; Eze, S; (2009) Is community-based health insurance an equitable strategy for paying for healthcare? Experiences from southeast Nigeria. Health policy (Amsterdam, Netherlands), 92 (1). pp. 96-102. ISSN 0168-8510 DOI: https://doi.org/10.1016/j.healthpol.2009.02.007

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Abstract

: To determine how equitable enrolment and utilization of community-based health insurance is in two communities with varying levels of success in implementing the scheme.<br/> : The study was undertaken in two communities in Anambra state, southeast Nigeria. Data was collected using a questionnaire that was administered to 971 respondents in two communities selected by simple random sampling. Data analysis examined socio-economic status (SES) differences in enrolment levels, utilization, willingness to renew registration and payments.<br/> : Enrolment level was 15.5% in the non-successful community and 48.4% in the successful community (p<0.0001). However, there was no inequity in enrolment, willingness to renew registration and utilization of services. Equal amounts of money were paid as registration fee and premium by all SES quartiles. There were no exemptions and no subsidies.<br/> : Enrolment was generally low and contributions were retrogressive. The average premiums were also small. However, there was equitable enrolment and utilization of services. Efforts need to be made to increase the number of enrolees, so as to increase the pool of funds and risks. Payments by enrolees especially in poor and rural communities should be supplemented by subsidies from government and donors in order to ensure equitable financial risk protection.<br/>

Item Type: Article
Keywords: Community Health Services/*economics, Data Interpretation, Statistical, Female, Financing, Government/*utilization, Health Services Accessibility/*economics, Humans, Insurance, Health/*utilization, Male, Nigeria, Planning Techniques, Questionnaires, Socioeconomic Factors, Utilization Review, Community Health Services, economics, Data Interpretation, Statistical, Female, Financing, Government, utilization, Health Services Accessibility, economics, Humans, Insurance, Health, utilization, Male, Nigeria, Planning Techniques, Questionnaires, Socioeconomic Factors, Utilization Review
Faculty and Department: Faculty of Public Health and Policy > Dept of Global Health and Development
PubMed ID: 19349091
Web of Science ID: 269273000013
URI: http://researchonline.lshtm.ac.uk/id/eprint/1692228

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