A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries

 

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dc.contributor.author Adebayo, Esther F
dc.contributor.author Uthman, Olalekan A
dc.contributor.author Wiysonge, Charles S
dc.contributor.author Stern, Erin A
dc.contributor.author Lamont, Kim T
dc.contributor.author Ataguba, John E
dc.date.accessioned 2016-01-14T08:29:27Z
dc.date.available 2016-01-14T08:29:27Z
dc.date.issued 2015-12-08
dc.identifier.citation BMC Health Services Research. 2015 Dec 08;15(1):543
dc.identifier.uri http://dx.doi.org/10.1186/s12913-015-1179-3
dc.identifier.uri http://hdl.handle.net/11427/16387
dc.description.abstract Background: Low-income and middle-income countries (LMICs) have difficulties achieving universal financial protection, which is primordial for universal health coverage. A promising avenue to provide universal financial protection for the informal sector and the rural populace is community-based health insurance (CBHI). We systematically assessed and synthesised factors associated with CBHI enrolment in LMICs. Methods: We searched PubMed, Scopus, ERIC, PsychInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL, Cochrane Library, conference proceedings, and reference lists for eligible studies available by 31 October 2013; regardless of publication status. We included both quantitative and qualitative studies in the review. Results: Both quantitative and qualitative studies demonstrated low levels of income and lack of financial resources as major factors affecting enrolment. Also, poor healthcare quality (including stock-outs of drugs and medical supplies, poor healthcare worker attitudes, and long waiting times) was found to be associated with low CBHI coverage. Trust in both the CBHI scheme and healthcare providers were also found to affect enrolment. Educational attainment (less educated are willing to pay less than highly educated), sex (men are willing to pay more than women), age (younger are willing to pay more than older individuals), and household size (larger households are willing to pay more than households with fewer members) also influenced CBHI enrolment. Conclusion: In LMICs, while CBHI schemes may be helpful in the short term to address the issue of improving the rural population and informal workers’ access to health services, they still face challenges. Lack of funds, poor quality of care, and lack of trust are major reasons for low CBHI coverage in LMICs. If CBHI schemes are to serve as a means to providing access to health services, at least in the short term, then attention should be paid to the issues that militate against their success.
dc.title A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries
dc.type Journal Article
dc.date.updated 2015-12-09T19:03:11Z
dc.language.rfc3066 en
dc.rights.holder Adebayo et al.
uct.type.publication Research en_ZA
uct.type.resource Article en_ZA
dc.publisher.institution University of Cape Town
dc.publisher.faculty Faculty of Health Sciences en_ZA
dc.publisher.department Department of Public Health and Family Medicine en_ZA
uct.type.filetype
uct.type.filetype Text
uct.type.filetype Image
dc.identifier.apacitation Adebayo, E. F., Uthman, O. A., Wiysonge, C. S., Stern, E. A., Lamont, K. T., & Ataguba, J. E. (2015). A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries. http://hdl.handle.net/11427/16387 en_ZA
dc.identifier.chicagocitation Adebayo, Esther F, Olalekan A Uthman, Charles S Wiysonge, Erin A Stern, Kim T Lamont, and John E Ataguba "A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries." (2015) http://hdl.handle.net/11427/16387 en_ZA
dc.identifier.vancouvercitation Adebayo EF, Uthman OA, Wiysonge CS, Stern EA, Lamont KT, Ataguba JE. A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries. 2015; http://hdl.handle.net/11427/16387. en_ZA
dc.identifier.ris TY - Journal Article AU - Adebayo, Esther F AU - Uthman, Olalekan A AU - Wiysonge, Charles S AU - Stern, Erin A AU - Lamont, Kim T AU - Ataguba, John E AB - Background: Low-income and middle-income countries (LMICs) have difficulties achieving universal financial protection, which is primordial for universal health coverage. A promising avenue to provide universal financial protection for the informal sector and the rural populace is community-based health insurance (CBHI). We systematically assessed and synthesised factors associated with CBHI enrolment in LMICs. Methods: We searched PubMed, Scopus, ERIC, PsychInfo, Africa-Wide Information, Academic Search Premier, Business Source Premier, WHOLIS, CINAHL, Cochrane Library, conference proceedings, and reference lists for eligible studies available by 31 October 2013; regardless of publication status. We included both quantitative and qualitative studies in the review. Results: Both quantitative and qualitative studies demonstrated low levels of income and lack of financial resources as major factors affecting enrolment. Also, poor healthcare quality (including stock-outs of drugs and medical supplies, poor healthcare worker attitudes, and long waiting times) was found to be associated with low CBHI coverage. Trust in both the CBHI scheme and healthcare providers were also found to affect enrolment. Educational attainment (less educated are willing to pay less than highly educated), sex (men are willing to pay more than women), age (younger are willing to pay more than older individuals), and household size (larger households are willing to pay more than households with fewer members) also influenced CBHI enrolment. Conclusion: In LMICs, while CBHI schemes may be helpful in the short term to address the issue of improving the rural population and informal workers’ access to health services, they still face challenges. Lack of funds, poor quality of care, and lack of trust are major reasons for low CBHI coverage in LMICs. If CBHI schemes are to serve as a means to providing access to health services, at least in the short term, then attention should be paid to the issues that militate against their success. DA - 2015-12-08 DB - OpenUCT DO - 10.1186/s12913-015-1179-3 DP - University of Cape Town LK - https://open.uct.ac.za PB - University of Cape Town PY - 2015 T1 - A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries TI - A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries UR - http://hdl.handle.net/11427/16387 ER - en_ZA


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