Assessment of community-based health insurance systems in Ethiopia
January 2020 – September 2020
Bill & Melinda Gates Foundation
Ethiopian Health Insurance Agency
Category of project
This project had two main studies. The first study was conducted with the main objective of assessing the impact of CBHI on health service utilization, out-of-pocket payments, financial risk protection, and related outcomes among member households.
Study 1: specifically, assessed the effect of CBHI on:
* The utilization of health services
* Equity in health service utilization
* Catastrophic and impoverishing health expenditures among households
* Women’s empowerment in accessing health services
* Health service delivery among health facilities providing services to CBHI members
The second study under this project was conducted to estimate the willingness and ability to pay for CBHI membership among households in Ethiopia’s the informal sector.
Study 2: assessing WTP and ATP for CBHI membership among households in the informal sector and assessing factors associated with WTP for CBHI membership among households in the informal sector.
This project was conducted all over the country, in urban, agrarian, and pastoralist settings. In these two studies, 166 randomly selected enumeration areas were reached to get a total of 5,810 households and 101 health centers. Both qualitative and quantitative data were collected, which mainly focused on household consumption, market surveys, health service seeking and utilization, unmet healthcare needs, ability and willingness to pay via bidding games, disease occurrence, and issues related to equity. Moreover, the studies assessed the impact of CBHI in health service delivery with regards to the availability of basic resources and the status of service uptake. In this assessment, multiple categories of local and international professionals (eg., economists, evaluators, public health specialists, epidemiologists, statisticians, health system management experts, gender specialists, etc) were involved.