Publication: Social Inclusion and Financial Protection through Community Financing : Initial Results from Five Household Surveys
Date
2001-09
ISSN
Published
2001-09
Author(s)
Jakab, Melitta
Preker, Alexander S.
Krishnan, Chitra
Schneider, Pia
Diop, François
Jütting, Johannes
Gumber, Anil
Ranson, Kent
Supakankunt, Siripeni
Abstract
This paper provides empirical evidence
regarding the performance of community-based health care
financing in terms of (a) social inclusion and (b) financial
protection. Five non-standardized household surveys were
analyzed from India (two samples), Senegal, Rwanda, and
Thailand. Common methodology was applied to the five data
sets. Logistic regression was used to estimate the
determinants of enrolling in a community financing scheme. A
two-part model was used to assess the determinants of
financial protection: part one used logistic regression to
estimate the determinants of the likelihood of visiting a
health care provider; part two used ordinary least-squares
regression to estimate the determinants of out-of-pocket
payments. The research finds: (a) Social inclusion. The
findings suggest that community financing can be inclusive
of the poorest even in the most economically deprived
context. Nevertheless, this targeting outcome is not
automatically attributable to the involvement of the
community; rather it depends on key design and
implementation characteristics of the schemes. (b) Financial
protection. Community financing reduces financial barriers
to health care as demonstrated by higher utilization and
simultaneously lower out-of-pocket expenditure of scheme
members controlling for a range of socioeconomic variables.
The paper concludes: (a) Social inclusion. Design and
implementation characteristics of community financing
schemes matter to achieve good targeting outcome-community
involvement alone does not guarantee social inclusion.
Further research is needed to delineate which design and
implementation characteristics allow better inclusion of the
poor. (b) Financial protection. Prepayment and risk sharing,
even on a small scale, reduce financial access barriers.
Citation
“Jakab, Melitta; Preker, Alexander S.; Krishnan, Chitra; Schneider, Pia; Diop, François; Jütting, Johannes; Gumber, Anil; Ranson, Kent; Supakankunt, Siripeni. 2001. Social Inclusion and Financial Protection through Community Financing : Initial Results from Five Household Surveys. HNP discussion paper series;. © World Bank, Washington, DC. http://openknowledge.worldbank.org/entities/publication/bee11c68-1bb7-5328-8d83-510762987585 License: CC BY 3.0 IGO.”