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Feasibility and Sustainability of Community Based Health Insurance in Rural Areas Case Study of Musana, Zimbabwe

Lazarus Muchabaiwa, Lloyd Chigusiwa, Samuel Bindu, Victoria Mudavanhu, David Damiyano and Bongani Edwin Mushanyuri
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Lazarus Muchabaiwa: Bindura University of Science Education, Zimbabwe
Lloyd Chigusiwa: Bindura University of Science Education, Zimbabwe
Samuel Bindu: Bindura University of Science Education, Zimbabwe
Victoria Mudavanhu: Bindura University of Science Education, Zimbabwe
David Damiyano: Bindura University of Science Education, Zimbabwe
Bongani Edwin Mushanyuri: Bindura University of Science Education, Zimbabwe

Expert Journal of Finance, 2017, vol. 5, 73-85

Abstract: The Zimbabwe Demographic Health Survey (ZDHS 2010-11) showed that only 6 percent of the population is covered by health insurance in Zimbabwe. This study investigated the feasibility, acceptability and sustainability of Community Based Health Insurance (CBHI) as an alternative to pooling risk and financing social protection in Zimbabwe. Willingness to Pay (WTP) for health insurance and socioeconomic data were collected through interviews with 121 household heads selected using a 2-stage sampling procedure on 14 villages in Musana and Domboshava rural areas, a population which is largely unemployed and reliant on subsistence agriculture. A CBHI scheme was established and followed up for 3 years documenting data on visits made, financial contributions from recruited households and their actual health expenditures. Findings indicate that CBHI is generally accepted as a means of health insurance in rural communities. The median willingness to pay for health insurance was $5.43 against monthly expenditures ranging of up to $180. The low WTP is attributable to low incomes as only 3.4 percent of the respondents relied on formal employment. Trust issues, adverse selection, moral hazard, and administration costs were challenges threatening sustainability of CBHI. A financial gap averaging 42% was generally on a downward trend and was closed by the end of the follow-up study as contributions were equivalent to medical expenses. We conclude that CBHI is feasible, has potential for sustainability and should be considered as a springboard for the planned Zimbabwean National Health Insurance.

Keywords: Community Based Health Insurance; Health Financing; Social Protection (search for similar items in EconPapers)
JEL-codes: I13 I15 I18 (search for similar items in EconPapers)
Date: 2017
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