Всего публикаций в данном разделе: 2
Social protection in rural areas of developing countries: Investigating the impact of community based health insurance in rural Senegal /доклад на 10 конгрессе ЕААЕ, Exploring Diversity in the European Agri-Food System, Zaragoza, Spain, 28-31 August 2002 [книги]
Опубликовано на портале: 29-11-2003Johannes Jutting
Community based health insurance schemes are becoming increasingly recognized as an instrument which help farmers in rural areas of low income countries to better manage health. Health risks present a permanent threat to the income earning capacity of poor people. Beside direct economic cost for treatment and lost working time, indirect cost such as a reduction in labor supply materialize which increases the vulnerability of the household. It is often hypothesized that community based health insurance improve social protection, but quantitative analysis is largely missing. Against this background, this paper analyzes if members in a mutual health insurance scheme have a better access to health care than non-members taking “les mutuelles de santés” (mutual health organization) in rural Senegal as an example. Limited dependent and log linear regressions are used to capture the impact of health insurance on the probability of visiting a health care provider and the out-of-pocket expenditure at the point of use . The results of the analysis show that while community based health insurance schemes reach otherwise excluded people, the poorest of the poor in the communities are not covered. Regarding the impact on the access to health care, members have a higher probability of using hospitalization services compared to non-members and pay substantially less when they need care. Given the results from this study, community financing schemes have the potential to improve the risk management capacity of rural households.
Provision of public goods in the transition process: Empirical evidence on access to health care in rural regions of Russia /доклад на 10 конгрессе ЕААЕ, Exploring Diversity in the European Agri-Food System, Zaragoza, Spain, 28-31 August 2002 [книги]
Опубликовано на портале: 30-11-2003Daniela Lohlein, Johannes Jutting, Peter Wehrheim
The objective of the paper is to identify the determinants of access to health care in rural Russia. We started out with the observation that the transition process has affected the provision of social services in the Russian Federation in general, and in rural areas in particular, owing to the overlap with agricultural reforms. Based on this observation we asked how the reduced role of the state and the concomitant decentralization of policy making has affected access of the rural populace to social services. A review of the available literature on this topic resulted in the formulation of the following three hypotheses. Firstly, that income is a determinant of access to health care. Secondly, that informal payments play an important role in determining access, and thirdly that there are large differences in access to health care services between districts. The hypotheses were tested using household data from a survey conducted in two regions of Russia in 2000. The results indicate that in the study regions, contrary to expectations, neither income nor informal payments are important determinants of access. However, there are large differences in out-of-pocket expenditures between districts, indicating that access to health care varies between districts.