By: |
Shimeles, Abebe (Development Research Department African Development Bank) |
Abstract: |
Community-based health insurance schemes (Mutuelles) in Rwanda are one of the
largest experiments in community based risk-sharing mechanisms in Sub-Saharan
Africa for health related problems. This study examines the impact of the
program on demand for modern health care, mitigation of out-of-pocket
catastrophic health expenditure and social inclusiveness based on a nationally
representative household survey using traditional regression approach and
matching estimator popular in the evaluation literature. Our findings suggest
that Mutuelles have been successful in increasing utilization of modern health
care services and reducing catastrophic health related expenditure. According
to our preferred method, higher utilization of health care services was found
among the insured non-poor than insured poor households, with comparable
effect in reducing health-related expenditure shocks. This reinforces the
inequity already inherent in the Mutuelles system.<p> |
Keywords: |
demand for health services; catastrophic health expenditure; average treatment effects; endogenous dummy variable; matching estimator |
JEL: |
I10 |
Date: |
2010–08–06 |
URL: |
http://d.repec.org/n?u=RePEc:hhs:gunwpe:0463&r=mfd |