The impact of community-based health insurance on universal health coverage in Ethiopia : a systematic review and meta-analysis
BACKGROUND: Ideally health insurance aims to provide financial security, promote social inclusion, and ensure equitable access to quality healthcare services for all households. Community-based health insurance has been operating in Ethiopia since 2011. However, its nationwide impact on universal health coverage has not yet been evaluated despite several studies being conducted.
OBJECTIVE: We evaluated the impact of Ethiopia's community-based health insurance (2012-2021) on universal health coverage.
METHODS: On 27 August 2022, searches were conducted in Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar. Twenty-three studies were included. We used the Joana Briggs Institute checklists to assess the risk of bias. We included cross-sectional and mixed studies with low and medium risk. The data were processed in Microsoft Excel and analyzed using RevMan-5. The impact was measured first on insured households and then on insured versus uninsured households. We used a random model to measure the effect estimates (odds ratios) with a p value < 0.05 and a 95% CI.
RESULTS: The universal health coverage provided by the scheme was 45.6% (OR = 1.92, 95% CI: 1.44-2.58). Being a member of the scheme increased universal health coverage by 24.8%. The healthcare service utilization of the beneficiaries was 64.5% (OR = 1.95, 95% CI: 1.29-2.93). The scheme reduced catastrophic health expenditure by 79.4% (OR = 4.99, 95% CI: 1.27-19.67). It yielded a 92% (OR = 11.58, 95% CI: 8.12-16.51) perception of health service quality. The health-related quality of life provided by it was 63% (OR = 1.71, 95% CI: 1.50-1.94). Its population coverage was 40.1% (OR = 0.64, 95% CI: 0.41-1.02).
CONCLUSION: Although the scheme had positive impacts on health service issues by reducing catastrophic costs, the low universal health coverage on a limited population indicates that Ethiopia should move to a broader national scheme that covers the entire population.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2023 |
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| Erschienen: |
2023 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:16 |
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| Enthalten in: |
Global health action - 16(2023), 1 vom: 31. Dez., Seite 2189764 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Bayked, Ewunetie Mekashaw [VerfasserIn] |
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| Links: |
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| Themen: |
Financial risk protection |
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| Anmerkungen: |
Date Completed 24.03.2023 Date Revised 28.03.2023 published: Print Citation Status MEDLINE |
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| doi: |
10.1080/16549716.2023.2189764 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM354526871 |
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| 100 | 1 | |a Bayked, Ewunetie Mekashaw |e verfasserin |4 aut | |
| 245 | 1 | 4 | |a The impact of community-based health insurance on universal health coverage in Ethiopia |b a systematic review and meta-analysis |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Ideally health insurance aims to provide financial security, promote social inclusion, and ensure equitable access to quality healthcare services for all households. Community-based health insurance has been operating in Ethiopia since 2011. However, its nationwide impact on universal health coverage has not yet been evaluated despite several studies being conducted | ||
| 520 | |a OBJECTIVE: We evaluated the impact of Ethiopia's community-based health insurance (2012-2021) on universal health coverage | ||
| 520 | |a METHODS: On 27 August 2022, searches were conducted in Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar. Twenty-three studies were included. We used the Joana Briggs Institute checklists to assess the risk of bias. We included cross-sectional and mixed studies with low and medium risk. The data were processed in Microsoft Excel and analyzed using RevMan-5. The impact was measured first on insured households and then on insured versus uninsured households. We used a random model to measure the effect estimates (odds ratios) with a p value < 0.05 and a 95% CI | ||
| 520 | |a RESULTS: The universal health coverage provided by the scheme was 45.6% (OR = 1.92, 95% CI: 1.44-2.58). Being a member of the scheme increased universal health coverage by 24.8%. The healthcare service utilization of the beneficiaries was 64.5% (OR = 1.95, 95% CI: 1.29-2.93). The scheme reduced catastrophic health expenditure by 79.4% (OR = 4.99, 95% CI: 1.27-19.67). It yielded a 92% (OR = 11.58, 95% CI: 8.12-16.51) perception of health service quality. The health-related quality of life provided by it was 63% (OR = 1.71, 95% CI: 1.50-1.94). Its population coverage was 40.1% (OR = 0.64, 95% CI: 0.41-1.02) | ||
| 520 | |a CONCLUSION: Although the scheme had positive impacts on health service issues by reducing catastrophic costs, the low universal health coverage on a limited population indicates that Ethiopia should move to a broader national scheme that covers the entire population | ||
| 650 | 4 | |a Meta-Analysis | |
| 650 | 4 | |a Systematic Review | |
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Review | |
| 650 | 4 | |a Financial risk protection | |
| 650 | 4 | |a health service quality | |
| 650 | 4 | |a health-related quality of life | |
| 650 | 4 | |a healthcare seeking behavior | |
| 650 | 4 | |a population coverage | |
| 700 | 1 | |a Toleha, Husien Nurahmed |e verfasserin |4 aut | |
| 700 | 1 | |a Kebede, Seble Zewdu |e verfasserin |4 aut | |
| 700 | 1 | |a Workneh, Birhanu Demeke |e verfasserin |4 aut | |
| 700 | 1 | |a Kahissay, Mesfin Haile |e verfasserin |4 aut | |
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