Poor people lack access to health care with a negative impact on their
dignity, human capital formation and their risk-management options.
Recently an emerging movement of community-based health insurance
schemes has attracted the attention of policy makers and researchers as
it seems that these schemes target the poor more efficiently. Taking the
example of community-based health insurance schemes in rural Senegal
this paper identifies the factors explaining participation in these
schemes. Using household survey data of non-members and members, we
found that household income, religion, village characteristics and the
belonging to a certain ethnic group exert the strongest influence on the
probability of participation. From these findings, it follows that i)
although the schemes reach the \"poor\" in general, the \"poorest of the
poor\" within the villages find it financially difficult to participate;
ii) social exclusion due to religion or ethnic group might persist.
Several options for designing the schemes in order to address these
weaknesses are discussed.
Health insurance for the poor? Determinants of participation incommunity-based health insurance schemes in rural Senegal, presented at Staying Poor: Chronic Poverty and Development Policy, Institute for Development Policy and Management, University of Manchester, 7-9 April 2003. Chronic Poverty Research Centre (CPRC), Manchester, UK, 21 pp.