TY - JOUR
T1 - Uptake of Health Insurance and the Productive Safety Net Program in Rural Ethiopia
AU - Shuka, Zemzem Shigute
AU - Mebratie, Anagaw
AU - Sparrow, Robert
AU - Yilma, Z
AU - Alemu, G
AU - Bedi, Arjun
PY - 2017/1/23
Y1 - 2017/1/23
N2 - Due to lack of well-developed insurance and credit markets, rural families in Ethiopia are exposed to a
range of covariate and idiosyncratic risks. In 2005, to deal with the consequences of covariate risks, the
government implemented the Productive Safety Net Program (PSNP), and in 2011, to mitigate the
financial consequences of ill-health, the government introduced a pilot Community Based Health Insurance
(CBHI) Scheme. This paper explores whether scheme uptake and retention is affected by access
to the PSNP. Based on household panel data and qualitative information, the analysis shows that
participating in the PSNP increases the probability of CBHI uptake by 24 percentage points and enhances
scheme retention by 10 percentage points. A large proportion of this effect may be attributed to explicit
and implicit pressure applied by government officials on PSNP beneficiaries. Whether this is a desirable
approach is debatable. Nevertheless, the results suggest that membership in existing social protection
programs may be leveraged to spread new schemes and potentially accelerate poverty reduction efforts
AB - Due to lack of well-developed insurance and credit markets, rural families in Ethiopia are exposed to a
range of covariate and idiosyncratic risks. In 2005, to deal with the consequences of covariate risks, the
government implemented the Productive Safety Net Program (PSNP), and in 2011, to mitigate the
financial consequences of ill-health, the government introduced a pilot Community Based Health Insurance
(CBHI) Scheme. This paper explores whether scheme uptake and retention is affected by access
to the PSNP. Based on household panel data and qualitative information, the analysis shows that
participating in the PSNP increases the probability of CBHI uptake by 24 percentage points and enhances
scheme retention by 10 percentage points. A large proportion of this effect may be attributed to explicit
and implicit pressure applied by government officials on PSNP beneficiaries. Whether this is a desirable
approach is debatable. Nevertheless, the results suggest that membership in existing social protection
programs may be leveraged to spread new schemes and potentially accelerate poverty reduction efforts
U2 - 10.1016/j.socscimed.2017.01.035
DO - 10.1016/j.socscimed.2017.01.035
M3 - Article
SN - 0277-9536
VL - 176
SP - 133
EP - 141
JO - Social Science and Medicine
JF - Social Science and Medicine
IS - March
ER -