Community-based health financing and child stunting in rural Rwanda

C. Lu, I. Mejia-Guevara, K. Hill, P. Farmer, S.V. Subramanian and A. Binagwaho

American Journal of Public Health, 2016, vol. 106, issue 1, 49-55

Abstract: Objectives. We analyzed the likelihood of rural children (aged 6-24 months) being stunted according to whether they were enrolled in Mutuelles, a community-based health-financing program providing health insurance to rural populations and granting them access to health care, including nutrition services. Methods. We retrieved health facility data from the District Health System Strengthening Tool and calculated the percentage of rural health centers that provided nutrition-related services required by Mutuelles' minimum service package. We used data from the 2010 Rwanda Demographic and Health Survey and performed multilevel logistic analysis to control for clustering effects and sociodemographic characteristics. The final sample was 1061 children. Results. Among 384 rural health centers, more than 90% conducted nutrition-related campaigns and malnutrition screening for children. Regardless of poverty status, the risk of being stunted was significantly lower (odds ratio = 0.60; 95% credible interval = 0.41, 0.83) for Mutuelles enrollees. This finding was robust to various model specifications (adjusted for Mutuelles enrollment, poverty status, other variables) or estimation methods (fixed and random effects). Conclusions. This study provides evidence of the effectiveness of Mutuelles in improving child nutrition status and supported the hypothesis about the role of Mutuelles in expanding medical and nutritional care coverage for children.

Keywords: dietary service; economics; Growth Disorders; health; health care delivery; health care financing; health insurance; human; infant; prevalence; rural health care; Rwanda; standards; statistics and numerical data; supply and distribution, Dietary Services; Growth Disorders; Health Services Accessibility; Healthcare Financing; Humans; Infant; Insurance, Health; Prevalence; Rural Health; Rural Health Services; Rwanda (search for similar items in EconPapers)
Date: 2016
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Citations: View citations in EconPapers (4)

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Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2015.302913_5

DOI: 10.2105/AJPH.2015.302913

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