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Periodical article | Leiden University catalogue | WorldCat |
Title: | The Emerging Movement of Community Based Health Insurance in Sub-Saharan Africa: Experiences and Lessons Learned |
Authors: | Wiesmann, Doris Jütting, Johannes |
Year: | 2000 |
Periodical: | Afrika Spectrum |
Volume: | 35 |
Issue: | 2 |
Pages: | 193-210 |
Language: | English |
Geographic terms: | Subsaharan Africa Africa |
Subjects: | health insurance health financing Health and Nutrition Economics and Trade Development and Technology |
Abstract: | The majority of sub-Saharan African citizens - informal sector workers and rural population - have never had access to wage-based social health insurance or privately run health insurance. As a response to the lack of social security, to the negative side effects of user fees introduced in the 1980s and to persistent problems with health care financing, non-profit, voluntary community-based health insurance (CBHI) schemes for urban and rural self-employed and informal sector workers have recently emerged. This paper describes the economic aspects of CBHI schemes, shows their geographical distribution in sub-Saharan Africa together with their size and period of foundation, and summarizes experiences and lessons learned from their implementation. It concludes that the actual implementation of CBHI schemes has had mixed results so far, with success and viability largely depending on design and management of the scheme, community participation, regulations at the level of the health care provider, quality of services and the socioeconomic and cultural context. Bibliogr., notes, ref., sum. in English, German and French. |