Impact of Community-Based Health Insurance on Child Health Outcomes: Evidence on Stunting from Rural Uganda

ZEF-Discussion Papers on Development Policy No. 269 (2019)

44 Pages Posted: 25 Jan 2019

See all articles by Emmanuel Nshakira-Rukundo

Emmanuel Nshakira-Rukundo

University of Bonn - Center for Development Research (ZEF)

Essa Mussa

University of Bonn - Center for Development Research (ZEF)

Nicolas Gerber

University of Bonn - Center for Development Research (ZEF)

Joachim von Braun

University of Bonn - Department of Economic and Technological Change

Date Written: January 14, 2019

Abstract

While community-based health insurance (CBHI) becomes increasingly integrated into health systems in developing countries, there is still limited research and evidence on its probable health impacts beyond its functions for health financing or for facilitating access to services. Using a cross-sectional data from rural south-west Uganda, we apply a two-stage residual inclusion instrumental variables method to study the impact of community health insurance on stunting in children under five years. Results indicate that each year a household was enrolled in insurance was causally associated with a reduction in the probability of stunting of 5.7 percentage points. Predictive marginal effects show that children in households which have had insurance for at least 5 years had a probability of stunting of only 0.353 compared to 0.531 for children in households with no insurance. Households in CBHI were more likely to attend more free antenatal and postnatal care visits and report fewer illnesses and reported less health expenditures. Moreover, CBHI enrolment was also associated with reduced health costs. We recommend that developing countries should facilitate the expansion of community health insurance scheme not only for their contribution to health financing but even more for mortality and morbidity aversion.

Keywords: Community-based health insurance, Child Stunting, Two-Stage Residual Inclusion, Rural Uganda

JEL Classification: I130, I150, I100, I555

Suggested Citation

Nshakira-Rukundo, Emmanuel and Mussa, Essa and Gerber, Nicolas and von Braun, Joachim, Impact of Community-Based Health Insurance on Child Health Outcomes: Evidence on Stunting from Rural Uganda (January 14, 2019). ZEF-Discussion Papers on Development Policy No. 269 (2019). Available at SSRN: https://ssrn.com/abstract=3315201 or http://dx.doi.org/10.2139/ssrn.3315201

Emmanuel Nshakira-Rukundo (Contact Author)

University of Bonn - Center for Development Research (ZEF) ( email )

Walter-Flex-Str. 3
Bonn, NRW 53113
Germany

Essa Mussa

University of Bonn - Center for Development Research (ZEF) ( email )

Walter-Flex-Str. 3
Bonn, NRW 53113
Germany

Nicolas Gerber

University of Bonn - Center for Development Research (ZEF) ( email )

Walter-Flex-Strasse 3
Bonn, D-53113
Germany

Joachim Von Braun

University of Bonn - Department of Economic and Technological Change ( email )

Walter-Flex-Str. 3
Bonn, 53113
Germany

Register to save articles to
your library

Register

Paper statistics

Downloads
14
Abstract Views
127
PlumX Metrics