Community-based health insurance in low-income countries: a systematic review of the evidence
TLDR
The main policy implication of the review is that these types of community financing arrangements are, at best, complementary to other more effective systems of health financing.Abstract:
Health policy makers are faced with competing alternatives, and for systems of health care financing. The choice of financing method should mobilize resources for health care and provide financial protection. This review systematically assesses the evidence of the extent to which community-based health insurance is a viable option for low-income countries in mobilizing resources and providing financial protection. The review contributes to the literature on health financing by extending and qualifying existing knowledge. Overall, the evidence base is limited in scope and questionable in quality. There is strong evidence that community-based health insurance provides some financial protection by reducing out-of-pocket spending. There is evidence of moderate strength that such schemes improve cost-recovery. There is weak or no evidence that schemes have an effect on the quality of care or the efficiency with which care is produced. In absolute terms, the effects are small and schemes serve only a limited section of the population. The main policy implication of the review is that these types of community financing arrangements are, at best, complementary to other more effective systems of health financing. To improve reliability and validity of the evidence base, analysts should agree on a more coherent set of outcome indicators and a more consistent assessment of these indicators. Policy makers need to be better informed as to both the costs and the benefits of implementing various financing options. The current evidence base on community-based health insurance is mute on this point.read more
Citations
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Addressing access barriers to health services: an analytical framework for selecting appropriate interventions in low-income Asian countries
TL;DR: An overview of the various dimensions of barriers to access to health care in low-income countries (geographical access, availability, affordability and acceptability) is provided and existing interventions designed to overcome these barriers are outlined.
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Catastrophic household expenditure for health care in a low-income society: a study from Nouna District, Burkina Faso
TL;DR: It is concluded that the poorest members of the community incurred catastrophic health expenses, and this has important policy implications and can be used to ensure better access to health services and a higher degree of financial protection for low-income groups against the economic impact of illness.
Journal ArticleDOI
Community-based health insurance in developing countries: a study of its contribution to the performance of health financing systems.
TL;DR: The proposals pertain to the demand for and the supply of health care in the community; to the technical, managerial and institutional set‐up of CHI; and to the rational use of subsidies.
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Guideline implementation for breast healthcare in low- and middle-income countries: early detection resource allocation.
Cheng Har Yip,Robert A. Smith,Benjamin O. Anderson,Benjamin O. Anderson,Anthony B. Miller,David B. Thomas,Eng Suan Ang,Rosemary S. Caffarella,Marilys Corbex,Gary L. Kreps,Anne McTiernan +10 more
TL;DR: The effectiveness and efficiency of screening modalities, including screening mammography, clinical breast examination (CBE), and breast self‐examination, were reviewed in the context of resource availability and population‐based need by the panel.
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To retain or remove user fees?: reflections on the current debate in low- and middle-income countries.
Chris James,Kara Hanson,Barbara McPake,Dina Balabanova,Davidson R. Gwatkin,Ian Hopwood,Christina Kirunga,Rudolph Knippenberg,Bruno Meessen,Saul S. Morris,Alexander S. Preker,Yves Souteyrand,Abdelmajid Tibouti,Abdelmajid Tibouti,Pascal Villeneuve,Ke Xu +15 more
TL;DR: Reflections on the recent user fees debate are provided, drawing from the evidence presented and subsequent discussions at a recent UNICEF consultation on user fees in the health sector, and relates the debate to the wider issue of access to adequate healthcare.
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