The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda

39 Pages Posted: 8 Apr 2019

See all articles by Andinet Woldemichael

Andinet Woldemichael

African Development Bank Group

Daniel Gurara

International Monetary Fund (IMF)

Abebe Shimeles

Göteborg University

Date Written: February 2019

Abstract

Achieving universal health coverage, including financial risk protection and access to quality essential health-care services, is one of the main Sustainable Development Goals. In low-income countries, innovative and affordable health financing systems are key to realize these goals. This paper assesses the impacts of Community-Based Health Insurance Scheme in Rwanda on health-related financial risks using a nationally representative household survey data collected over a ten-year period. We find that the scheme significantly reduce annual per capita out-of-pocket spending by about 3,600 Rwandan Franc (about US$12) or about 83 percent of average per capita healthcare expenditure compared to the baseline level in 2000.The impacts however favor the rich as compared to the poor. The program also reduces the incidence of catastrophic healthcare spending significantly.

Keywords: Consumer price indexes, Demographic indicators, Health insurance, Poverty, Health care, Healthcare spending, low-income, Rwanda, out-of-pocket, treatment effect, endogeneity, quartile, healthcare service

JEL Classification: C21, C34, D04, I13, I15, E01, J3, G22, I3, Z13

Suggested Citation

Woldemichael, Andinet and Gurara, Daniel and Shimeles, Abebe, The Impact of Community Based Health Insurance Schemes on Out-of-Pocket Healthcare Spending: Evidence from Rwanda (February 2019). IMF Working Paper No. 19/38. Available at SSRN: https://ssrn.com/abstract=3367423

Andinet Woldemichael (Contact Author)

African Development Bank Group ( email )

15 Avenue du Ghana
P.O.Box 323-1002
Tunis-Belvedère
Tunisia

Daniel Gurara

International Monetary Fund (IMF) ( email )

700 19th Street, N.W.
Washington, DC 20431
United States

Abebe Shimeles

Göteborg University ( email )

Viktoriagatan 30
Göteborg, 405 30
Sweden

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