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Socioeconomic and programmatic determinants of renewal of membership in a voluntary micro health insurance scheme: evidence from Chakaria, Bangladesh
- Source :
- Global Health Action, Vol 10, Iss 1 (2017), Global Health Action
- Publication Year :
- 2017
- Publisher :
- Taylor & Francis Group, 2017.
-
Abstract
- Background: Out-of-pocket (OOP) healthcare expenditure is a major obstacle for achieving universal health coverage in low-income countries including Bangladesh. Sixty-three percent of the USD 27 annual per-capita healthcare expenditure in Bangladesh comes from individuals’ pockets. Although health insurance is a financial tool for reducing OOP, use of such tools in Bangladesh has been limited to some small-scale voluntary micro health insurance (MHI) schemes run by non-governmental organizations (NGO). The MHI, however, can orient people on health insurance concept and provide learning for product development, implementation, barriers to enrolment, membership renewal, and other operational challenges and solutions. Keeping this in mind, icddr,b in 2012 initiated a pilot MHI, Amader Shasthya, in Chakaria, Bangladesh. This paper explores the determinants of membership renewal in this scheme, which is a perpetual challenge for MHI. Objective: Identify socioeconomic and programmatic determinants and their effects on membership renewal in a voluntary MHI scheme. Methods: Data came from the online management information system of the scheme and Health and Demographic Surveillance System of Chakaria, covering the period February 2012–May 2015. Association between renewal and independent variables was examined using cross-tabular and logistic regression analyses. Results: Nearly 20% of households in the catchment area ever enroled in the scheme, and 38% renewed membership over the initial 3 years of operation. Frequency of consultation with healthcare providers, benefits received, proximity of member’s residence to health facility, socioeconomic status, educational level, and age of the household head showed significant positive association with renewal of membership. Conclusions: Villagers’ enrolment in the scheme indicated that even in poor economic and literacy conditions people can be motivated to enrol in insurance schemes. Degree of service utilization and benefits received can greatly enhance the probability of membership renewal, which can be ensured with good quality of services and ease of access.
- Subjects :
- Adult
Male
Economic growth
service utilization
Micro health insurance
Article
03 medical and health sciences
0302 clinical medicine
Service utilization
Health care
Economics
Health insurance
Humans
030212 general & internal medicine
Poverty
Socioeconomic status
Bangladesh
Organizations
Insurance, Health
030505 public health
business.industry
Health Policy
benefit
lcsh:Public aspects of medicine
Age Factors
Public Health, Environmental and Occupational Health
determinants
lcsh:RA1-1270
Middle Aged
membership renewal
enrolment
Socioeconomic Factors
Turnover
Obstacle
New product development
Original Article
Female
Health Expenditures
0305 other medical science
business
Subjects
Details
- Language :
- English
- ISSN :
- 16549880 and 16549716
- Volume :
- 10
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Global Health Action
- Accession number :
- edsair.doi.dedup.....40504cb02ab48674d47413fa5c721c6a