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Uptake of health insurance and the productive safety net program in rural Ethiopia

Author

Listed:
  • Shigute, Zemzem
  • Mebratie, Anagaw D.
  • Sparrow, Robert
  • Yilma, Zelalem
  • Alemu, Getnet
  • Bedi, Arjun S.
Abstract
Due to lack of well-developed insurance and credit markets, rural families in Ethiopia are exposed to a range of covariate and idiosyncratic risks. In 2005, to deal with the consequences of covariate risks, the government implemented the Productive Safety Net Program (PSNP), and in 2011, to mitigate the financial consequences of ill-health, the government introduced a pilot Community Based Health Insurance (CBHI) Scheme. This paper explores whether scheme uptake and retention is affected by access to the PSNP. Based on household panel data and qualitative information, the analysis shows that participating in the PSNP increases the probability of CBHI uptake by 24 percentage points and enhances scheme retention by 10 percentage points. A large proportion of this effect may be attributed to explicit and implicit pressure applied by government officials on PSNP beneficiaries. Whether this is a desirable approach is debatable. Nevertheless, the results suggest that membership in existing social protection programs may be leveraged to spread new schemes and potentially accelerate poverty reduction efforts.

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  • Shigute, Zemzem & Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Alemu, Getnet & Bedi, Arjun S., 2017. "Uptake of health insurance and the productive safety net program in rural Ethiopia," Social Science & Medicine, Elsevier, vol. 176(C), pages 133-141.
    • Handle: RePEc:eee:socmed:v:176:y:2017:i:c:p:133-141
    DOI: 10.1016/j.socscimed.2017.01.035
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    2. Lavers, Tom, 2019. "Towards Universal Health Coverage in Ethiopia's ‘developmental state’? The political drivers of health insurance," Social Science & Medicine, Elsevier, vol. 228(C), pages 60-67.
    3. Lavers, Tom, 2021. "Aiming for Universal Health Coverage through insurance in Ethiopia: State infrastructural power and the challenge of enrolment," Social Science & Medicine, Elsevier, vol. 282(C).
    4. Shigute, Zemzem & Strupat, Christoph & Burchi, Francesco & Alemu, Getnet & Bedi, Arjun S., 2017. "The Joint Effects of a Health Insurance and a Public Works Scheme in Rural Ethiopia," IZA Discussion Papers 10939, Institute of Labor Economics (IZA).
    5. Tom Lavers, 2016. "Social protection in an aspiring ‘developmental state’: The political drivers of community-based health insurance in Ethiopia," Global Development Institute Working Paper Series esid-071-16, GDI, The University of Manchester.
    6. Hirvonen, Kalle & Bossuyt, Anne & Pigois, Remy, 2017. "Complementarities between social protection and health sector policies: Evidence from the Productive Safety Net Program in Ethiopia," ESSP working papers 112, International Food Policy Research Institute (IFPRI).
    7. Tadesse, Getaw & Zewdie, Tadiwos, 2019. "Grants vs. credits for improving the livelihoods of ultra-poor: Evidence from Ethiopia," World Development, Elsevier, vol. 113(C), pages 320-329.
    8. Kalle Hirvonen & Anne Bossuyt & Remy Pigois, 2021. "Evidence from the Productive Safety Net Programme in Ethiopia: Complementarities between social protection and health policies," Development Policy Review, Overseas Development Institute, vol. 39(4), pages 532-547, July.
    9. Mebratie, Anagaw D. & Sparrow, Robert & Yilma, Zelalem & Abebaw, Degnet & Alemu, Getnet & Bedi, Arjun S., 2019. "The impact of Ethiopia's pilot community based health insurance scheme on healthcare utilization and cost of care," Social Science & Medicine, Elsevier, vol. 220(C), pages 112-119.
    10. Mussa, Essa Chanie & Otchere, Frank & Vinci, Vincenzo & Reshad, Abduljelil & Palermo, Tia, 2021. "Linking poverty-targeted social protection and Community Based Health Insurance in Ethiopia: Enrolment, linkages, and gaps," Social Science & Medicine, Elsevier, vol. 286(C).
    11. Kiros Tsegay & Hongzhong Fan & AM Priyangani Adikari & Hailay Shifare, 2021. "Does gender matter for household livelihood diversification in Ethiopia rural areas?," International Journal of Research in Business and Social Science (2147-4478), Center for the Strategic Studies in Business and Finance, vol. 10(6), pages 221-232, September.
    12. Biggeri, M. & Nannini, M. & Putoto, G., 2018. "Assessing the feasibility of community health insurance in Uganda: A mixed-methods exploratory analysis," Social Science & Medicine, Elsevier, vol. 200(C), pages 145-155.

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    More about this item

    Keywords

    Ethiopia; Productive safety net program; Community based health insurance; Uptake of health insurance;
    All these keywords.

    JEL classification:

    • J65 - Labor and Demographic Economics - - Mobility, Unemployment, Vacancies, and Immigrant Workers - - - Unemployment Insurance; Severance Pay; Plant Closings
    • J48 - Labor and Demographic Economics - - Particular Labor Markets - - - Particular Labor Markets; Public Policy
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private

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