The Joint Effects of a Health Insurance and a Public Works Scheme in Rural Ethiopia

42 Pages Posted: 31 Aug 2017 Last revised: 26 Apr 2023

See all articles by Zemzem Shigute

Zemzem Shigute

Erasmus University Rotterdam (EUR) - Institute of Social Studies (ISS)

Christoph Strupat

Deutsches Institut für Entwicklungspolitik (DIE) - German Development Institute (DIE)

Francesco Burchi

German Institute of Development and Sustainability (IDOS)

Getnet Alemu

Addis Ababa University

Arjun S. Bedi

Erasmus University Rotterdam - International Institute of Social Studies; IZA Institute of Labor Economics

Abstract

Rural households in Ethiopia are exposed to a variety of covariate and idiosyncratic risks. In 2005, the Ethiopian government introduced the Productive Safety Net Program (PSNP) and in 2011 launched the Community Based Health Insurance Scheme (CBHI). This paper analyses the interaction between the two schemes and their joint effect on health care utilization, labor supply, asset accumulation and borrowing. The empirical analysis relies on three rounds of individual-level panel data collected in 2011, 2012 and 2013 and on several rounds of qualitative work.We find that individuals covered by both programs, as opposed to neither, are 5 percentage points more likely to use outpatient care and are 21 percentage points more likely to participate in off-farm work. Furthermore, participation in both programs is associated with a 5 percent increase in livestock, the main household asset, and a 27 percent decline in debt. These results suggest that at least in Ethiopia bundling of interventions enhances protection against multiple risks and shows the potential of linked social protection schemes.

Keywords: Productive Safety Net Program, Community Based Health Insurance Scheme, Ethiopia, joint effect

JEL Classification: J22, I15

Suggested Citation

Shigute, Zemzem and Strupat, Christoph and Burchi, Francesco and Alemu, Getnet and Bedi, Arjun S., The Joint Effects of a Health Insurance and a Public Works Scheme in Rural Ethiopia. IZA Discussion Paper No. 10939, Available at SSRN: https://ssrn.com/abstract=3029810 or http://dx.doi.org/10.2139/ssrn.3029810

Zemzem Shigute (Contact Author)

Erasmus University Rotterdam (EUR) - Institute of Social Studies (ISS) ( email )

PO Box 29776
Den Haag, 2518 AX
Netherlands

Christoph Strupat

Deutsches Institut für Entwicklungspolitik (DIE) - German Development Institute (DIE) ( email )

Tulpenfeld 4
Bonn, 53113
Germany

Francesco Burchi

German Institute of Development and Sustainability (IDOS) ( email )

Tulpenfeld 6
Bonn, 53113
Germany

Getnet Alemu

Addis Ababa University ( email )

King George VI St
Addis Ababa, 1000
Ethiopia

Arjun S. Bedi

Erasmus University Rotterdam - International Institute of Social Studies ( email )

PO Box 29776
2502 LT The Hague, 2518 AX
Netherlands
+31 70 426 0493 (Phone)
+31 70 426 0799 (Fax)

IZA Institute of Labor Economics

P.O. Box 7240
Bonn, D-53072
Germany

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