The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis

References

• The World Bank Group. Universal health coverage. Washington (DC): World Bank; 2022 [updated Oct]. Available from: https://www.worldbank.org/en/topic/universalhealthcoverage
   Google Scholar
• Gera R, Narwal R, Jain M, Taneja G, Gupta S. Sustainable development goals: leveraging the global agenda for driving health policy reforms and achieving universal health coverage in India. Indian J Community Med. 2018;43:255–17.
   PubMed Web of Science ®Google Scholar
• Mathur MR, Williams DM, Reddy KS, Watt RG. Universal health coverage: a unique policy opportunity for oral health. J Dent Res. 2015;94:3S–5S.
   PubMed Web of Science ®Google Scholar
• Carter B, Roelen K, Enfield S, Avis W. Social protection topic guide. Brighton (UK): Institute of Development Studies; 2019.
   Google Scholar
• Mailman School of Public Health. Ethiopia| summary. New York (NY): Columbia University; 2019. Available from: https://www.publichealth.columbia.edu/research/comparative-health-policy-library/ethiopia-summary
   Google Scholar
• Zelelew H, Blanchet N, Won A. Health finance & governance [Internet]. North Bethesda (MD): Abt Associates; 2018 Apr. Available from: https://www.hfgproject.org/expanding-coverage-through-health-insurance-an-ongoing-process/
   Google Scholar
• Yeshiwas S, Kiflie M, Zeleke AA, Kebede M. Civil servants’ demand for social health insurance in Northwest Ethiopia. Arch Public Health. 2018;76:48.
   PubMed Web of Science ®Google Scholar
• Wang H, Switlick K, Ortiz C, Zurita B, Connor C. Design element 2. Choice of financing mechanisms. Africa health insurance handbook—how to make it work. Washington (DC): Health Systems 20/20 project, Abt Associates Inc; 2010. p. 13–20.
   Google Scholar
• Ly MS, Bassoum O, Faye A. Universal health insurance in Africa: a narrative review of the literature on institutional models. BMJ Global Health. 2022;7:e008219.
   PubMed Web of Science ®Google Scholar
• Donfouet HPP, Mahieu P-A. Community-based health insurance and social capital: a review. Health Econ Rev. 2012;2:5.
   PubMedGoogle Scholar
• Feleke S, Mitiku W, Zelelew H, Ashagari TD. Health finance & governance [Internet]. North Bethesda (MD): Abt Associates; 2015 Jan. Available from: https://www.hfgproject.org/ethiopias-community-based-health-insurance-step-road-universal-health-coverage/
   Google Scholar
• Lavers T. Towards universal health coverage in Ethiopia’s ‘developmental state’? The political drivers of health insurance. Soc Sci Med. 2019;228:60–67.
   PubMed Web of Science ®Google Scholar
• Mebratie AD, Sparrow R, Yilma Z, Alemu G, Bedi AS. Dropping out of Ethiopia’s community-based health insurance scheme. Health Policy Plann. 2015;30:1296–1306.
   PubMed Web of Science ®Google Scholar
• Kiros M. CBHI implementation in Ethiopia. Addis Ababa, Ethiopia: Ethiopian Health Insurance Service; 2021.
   Google Scholar
• Ethiopian Ministry of Health. Health financing. Annual performance report, 2013 EFY (2020/2021). Addis Ababa, Ethiopia: Ethiopian Ministry of Health; 2021. p. 135–142.
   Google Scholar
• World Health Organization. Community based health insurance. Geneva (CH): World Health Organization; 2020 [ updated 2020]. Available from: https://www.who.int/news-room/fact-sheets/detail/community-based-health-insurance-2020
   Google Scholar
• Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:71.
   PubMed Web of Science ®Google Scholar
• Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. BMJ. 2009;339:b2535.
   PubMed Web of Science ®Google Scholar
• Adams D. Publish or perish on Microsoft windows St Albans. United Kingdom: Tarma Software Research Ltd; 2016. Available from: https://harzing.com/resources/publish-or-perish/windows
   Google Scholar
• World Health Organization. Tracking universal health coverage: first global monitoring report. Geneva (CH): World Health Organization; 2015.
   Google Scholar
• Neri S, Ornaghi A. Health-care costs. In: Michalos A, editor. Encyclopedia of quality of life and well-being research. Dordrecht: Springer Netherlands; 2014. p. 2759–2760.
   Google Scholar
• Rahman T, Gasbarro D, Alam K. Financial risk protection from out-of-pocket health spending in low- and middle-income countries: a scoping review of the literature. Health Res Policy Syst. 2022;20:83.
   PubMed Web of Science ®Google Scholar
• Saksena P, Hsu J, Evans DB. Financial risk protection and universal health coverage: evidence and measurement challenges. PLOS Med. 2014;11:e1001701.
   PubMed Web of Science ®Google Scholar
• Kaplan RM, Hays RD. Health-related quality of life measurement in public health. Ann Rev Public Health. 2022;43:355–373.
   PubMed Web of Science ®Google Scholar
• Oberoi S, Chaudhary N, Patnaik S, Singh A. Understanding health seeking behavior. J Family Med Prim Care. 2016;5:463–464.
   PubMedGoogle Scholar
• Kieny M-P, Evans TG, Scarpetta S, Kelley ET, Klazinga N, Forde I, et al. Global state of health care quality. Delivering quality health services: a global imperative for universal health coverage. Washington (DC): World Health Organization, Organisation for Economic Co-operation and Development, and The World Bank; 2018. p. 27–39.
   Google Scholar
• Meyers EA. Health care services utilization. In: Boslaugh S, editor. Encyclopedia of epidemiology. Los Angeles (USA): SAGE Publications; 2008. p. 470–471.
   Google Scholar
• Sirag A, Mohamed nor N. Out-of-pocket health expenditure and poverty: evidence from a dynamic panel threshold analysis. Healthcare. 2021;9:536.
   Web of Science ®Google Scholar
• OECD/European Union. Population coverage for health care. Health at a glance: Europe 2018: state of health in the EU cycle. Paris/European Union, Brussels: OECD Publishing; 2018. p. 174–175.
   Google Scholar
• Yilma Z, Mebratie A, Sparrow R, Dekker M, Alemu G, Bedi AS. Impact of Ethiopia’s community based health insurance on household economic welfare. World Bank Econ Rev. 2015;29:S164–73.
   Web of Science ®Google Scholar
• Hallalo HA. Achieving universal health coverage through health financing reform: Ethiopian showcase. Health Econ Outcome Res Open Access. 2018;4:1–5.
   Google Scholar
• Mussa EC, Otchere F, Vinci V, Reshad A, Palermo T. Linking poverty-targeted social protection and community based health insurance in Ethiopia: enrolment, linkages, and gaps. Soc Sci Med. 2021;286:114312.
   PubMed Web of Science ®Google Scholar
• Shigute Z, Strupat C, Burchi F, Alemu G. Linking social protection schemes: the joint effects of a public works and a health insurance programme in Ethiopia. J Dev Stud. 2020;56:431–448.
   Web of Science ®Google Scholar
• Tesfagiorgis E. The impact of community-based health insurance on health service utilization in aneded woreda. Debre markos. Ethiopia: Debre Markos University; 2016. p. 378–395.
   Google Scholar
• Atnafu DD, Tilahun H, Alemu YM. Community-based health insurance and healthcare service utilisation, North-West, Ethiopia: a comparative, cross-sectional study. BMJ Open. 2018;8:e019613.
   PubMed Web of Science ®Google Scholar
• Tilahun H, Atnafu DD, Asrade G, Minyihun A, Alemu YM. Factors for healthcare utilization and effect of mutual health insurance on healthcare utilization in rural communities of South Achefer Woreda, North West. Ethiopia Health Econ Rev. 2018;8:15.
   PubMed Web of Science ®Google Scholar
• Merga BT, Balis B, Bekele H, Fekadu G. Health insurance coverage in Ethiopia: financial protection in the era of sustainable development goals (SDGs). Health Econ Rev. 2022;12:43.
   PubMed Web of Science ®Google Scholar
• Terefe B, Alemu TG, Techane MA, Wubneh CA, Assimamaw NT, Belay GM, et al. Spatial distribution and associated factors of community based health insurance coverage in Ethiopia: further analysis of Ethiopian demography and health survey, 2019. BMC Public Health. 2022;22:1523.
   PubMed Web of Science ®Google Scholar
• Kassie G, Tefera B. Effects of community-based health insurance on modern family planning utilization in Ethiopia [version 2; peer review: 1 approved with reservations, 1 not approved]. Gates Open Res. 2019;3:1461.
   Google Scholar
• Mebratie A, Sparrow R, Debebe Z, Abebaw D, Zewdu G, Bedi A. Impact of Ethiopian pilot community-based health insurance scheme on health-care utilisation: a household panel data analysis. Lancet. 2013;381:S92.
   Web of Science ®Google Scholar
• Habte A, Tamene A, Ejajo T, Dessu S, Endale F, Gizachew A, et al. Towards universal health coverage: the level and determinants of enrollment in the Community-Based Health Insurance (CBHI) scheme in Ethiopia: a systematic review and meta-analysis. PLoS ONE. 2022;17:e0272959.
   PubMed Web of Science ®Google Scholar
• Tahir A, Abdilahi AO, Farah AE. Pooled coverage of community based health insurance scheme enrolment in Ethiopia, systematic review and meta-analysis, 2016–2020. Health Econ Rev. 2022;12:38.
   PubMed Web of Science ®Google Scholar
• Seid A, Ahmed M. Association between health insurance enrolment and maternal health care service utilization among women in Ethiopia. BMC Public Health. 2021;21:2329.
   PubMed Web of Science ®Google Scholar
• Atnafu A, Gebremedhin T. Community-based health insurance enrollment and child health service utilization in Northwest Ethiopia: a cross-sectional case comparison study. Clinicoecon Outcomes Res. 2020;12:435–444.
   PubMed Web of Science ®Google Scholar
• Segahu ZA. The Contribution of Community Based Health Insurance (CBHI) in improving access and utilization of healthcare services: the case of ADEA District, East Shoa Zone, Oromia Region, Ethiopia [ Thesis]. Addis Ababa, Ethiopia: St. Mary’s University; 2018.
   Google Scholar
• Tiruneh M, Gebregergs GB, Birhanu D. Determinants of delay in seeking treatment among malaria patients in Dera district, NorthWest Ethiopia: a case control study. Afr Health Sci. 2018;18:552–559.
   PubMed Web of Science ®Google Scholar
• Simieneh MM, Yitayal M, Gelagay AA. effect of community-based health insurance on healthcare-seeking behavior for childhood illnesses among rural mothers in Aneded District, East Gojjam zone, Amhara Region, Northwest Ethiopia. Risk Manag Health Pol. 2021;14:1659–1668.
   PubMed Web of Science ®Google Scholar
• Alemayehu YK, Dessie E, Medhin G, Birhanu N, Hotchkiss DR, Teklu AM, et al. The impact of community-based health insurance on health service utilization and financial risk protection in Ethiopia. Res Square. 2022. DOI:10.21203/rs.3.rs-1525536/v1
   Google Scholar
• Mebratie AD, Sparrow R, Yilma Z, Abebaw D, Alemu G, Bedi AS. The impact of Ethiopia’s pilot community based health insurance scheme on healthcare utilization and cost of care. Soc Sci Med. 2019;220:112–119.
   PubMed Web of Science ®Google Scholar
• Demissie B, Negeri KG. Effect of community-based health insurance on utilization of outpatient health care services in Southern Ethiopia: a comparative cross-sectional study. Risk Manag Health Pol. 2020;13:141–153.
   PubMed Web of Science ®Google Scholar
• Moyehodie YA, Fenta SM, Mulugeta SS, Agegn SB, Yismaw E, Biresaw HB, et al. Factors associated with community based health insurance healthcare service utilization of households in South Gondar zone, Amhara, Ethiopia. A community-based cross-sectional study. Health Serv Insights. 2022;15:1–12.
   Web of Science ®Google Scholar
• Engida A. Health service utilization and associated factors among community based health insurance members in efratanagidm woreda in North Shewa Zone, Amhara Region, Ethiopia [ Thesis]. Debre Berhan, Ethiopia: Debre Berhan University; 2019.
   Google Scholar
• Abenet LA, Alemu BA, Alamirew M. The impact of community based health insurance scheme on health care utilization in North Achefer Woreda, West Gojjam zone, Amhara Region, Ethiopia. IJRAT. 2019;7:25–45.
   Google Scholar
• Dagnaw FT, Azanaw MM, Adamu A, Ashagrie T, Mohammed AA, Dawid HY, et al. Community-based health insurance, healthcare service utilization and associated factors in South Gondar zone Northwest, Ethiopia, 2021: a comparative cross-sectional study. PLoS ONE. 2022;17:e0270758.
   PubMed Web of Science ®Google Scholar
• Jembere MY. Community based health insurance scheme as a new healthcare financing approach in rural Ethiopia: role on access, use and quality of healthcare services, the case of Tehuledere District, South Wollo zone, Northeast Ethiopia. Family Med Med Sci Res. 2018;7:1–6.
   Google Scholar
• Girmay AM, Reta MT. Community-based health insurance service utilization and associated factors in Addis Ababa, Ethiopia. Pub Health Challenges. 2022;1:e18.
   Google Scholar
• Mekonen AM, Gebregziabher MG, Teferra AS. The effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia: a cross sectional study. PLoS ONE. 2018;13:e0205972.
   PubMed Web of Science ®Google Scholar
• Jembere MY. The role of community based health insurance scheme on financial protection and healthcare seeking behavior of households in Tehuledere District, Northeast Ethiopia. Int J Health Econ Pol. 2018;3:13–19.
   Google Scholar
• Asfaw DM, Shifaw SM, Belete AA, Aychiluhm SB. The impact of community-based health insurance on household’s welfare in Chilga District, Amhara regional state, Ethiopia. Front Pub Health. 2022;10:1–12.
   Web of Science ®Google Scholar
• Tefera BB, Kibret MA, Molla YB, Kassie G, Hailemichael A, Abate T, et al. The interaction of healthcare service quality and community-based health insurance in Ethiopia. PLoS ONE. 2021;16:e0256132.
   PubMed Web of Science ®Google Scholar
• Gebru T, Lentiro K. The impact of community-based health insurance on health-related quality of life and associated factors in Ethiopia: a comparative cross-sectional study. Health Qual Life Outcomes. 2018;16:110.
   PubMed Web of Science ®Google Scholar
• Siebert M. Cochrane UK [Internet]. London (UK): The Cochrane Collaboration; 2018 Nov. Available from: https://s4be.cochrane.org/blog/2018/11/29/what-is-heterogeneity/
   Google Scholar
• Cantley N. Cochrane UK [Internet]. London (UK): The Cochrane Collaboration; 2016 Jul. Available from: https://uk.cochrane.org/news/how-read-forest-plot
   Google Scholar
• Eregata GT, Hailu A, Memirie ST, Norheim OF. Measuring progress towards universal health coverage: national and subnational analysis in Ethiopia. BMJ Global Health. 2019;4:e001843.
   PubMed Web of Science ®Google Scholar
• Debie A, Khatri RB, Assefa Y. Contributions and challenges of healthcare financing towards universal health coverage in Ethiopia: a narrative evidence synthesis. BMC Health Serv Res. 2022;22:866.
   PubMed Web of Science ®Google Scholar
• Spaan E, Mathijssen J, Tromp N, McBain F, ten Have A, Baltussen R. The impact of health insurance in Africa and Asia: a systematic review. Bull World Health Organ. 2012;90:685–692.
   PubMed Web of Science ®Google Scholar
• Ethiopia Health Insurance Service. CBHI members’ registration and contribution (2011-2020 G.C). CBHI Trend Bulletin Addis Ababa, Ethiopia. 2020;3–11.
   Google Scholar
• Mulat AK, Mao W, Bharali I, Balkew RB, Yamey G. Scaling up community-based health insurance in Ethiopia: a qualitative study of the benefits and challenges. BMC Health Serv Res. 2022;22:473.
   PubMed Web of Science ®Google Scholar
• Carrin G, Mathauer I, Xu K, Evans DB. Universal coverage of health services: tailoring its implementation. Bull World Health Organ. 2008;86:857–863.
   PubMed Web of Science ®Google Scholar
• Dibaba A, Hadis M, Ababor S, Assefa Y. Improving health care financing in Ethiopia (SURE policy brief): an evidence-based policy brief. Addis Ababa, Ethiopia: Ethiopian Public Health Institute; 2014.
   Google Scholar
• Umeh CA. Challenges toward achieving universal health coverage in Ghana, Kenya, Nigeria, and Tanzania. Int J Health Plann Manage. 2018;33:794–805.
   PubMed Web of Science ®Google Scholar
• Osei Afriyie D, Krasniq B, Hooley B, Tediosi F, Fink G. Equity in health insurance schemes enrollment in low and middle-income countries: a systematic review and meta-analysis. Int J Equity Health. 2022;21:21.
   PubMed Web of Science ®Google Scholar
• Wang H, Switlick K, Ortiz C, Zurita B, Connor C. Design element 3. Population coverage. Africa health insurance handbook—how to make it work. Washington (DC): Health Systems 20/20 project, Abt Associates Inc.; 2010. p. 21–29.
   Google Scholar
• Umeh CA, Feeley FG. Inequitable access to health care by the poor in community-based health insurance programs: a review of studies from low- and middle-income countries. Global Health. 2017;5:299–314.
   Google Scholar
• Mathauer I, Behrendt T. State budget transfers to health insurance to expand coverage to people outside formal sector work in Latin America. BMC Health Serv Res. 2017;17:145.
   PubMed Web of Science ®Google Scholar
• Vilcu I, Probst L, Dorjsuren B, Mathauer I. Subsidized health insurance coverage of people in the informal sector and vulnerable population groups: trends in institutional design in Asia. Int J Equity Health. 2016;15:165.
   PubMed Web of Science ®Google Scholar
• Erlangga D, Suhrcke M, Ali S, Bloor K. The impact of public health insurance on health care utilisation, financial protection and health status in low- and middle-income countries: a systematic review. PLoS ONE. 2019;14:e0219731.
   PubMed Web of Science ®Google Scholar
• Comfort AB, Peterson LA, Hatt LE. Effect of health insurance on the use and provision of maternal health services and maternal and neonatal health outcomes: a systematic review. J Health Popul Nutr. 2013;31:S81–105.
   PubMed Web of Science ®Google Scholar
• Guindon GE. The impact of health insurance on health services utilization and health outcomes in vietnam. Health Econ Policy Law. 2014;9:359–382.
   PubMed Web of Science ®Google Scholar
• Devadasan N, Criel B, Van Damme W, Manoharan S, Sarma PS, Van der Stuyft P. Community health insurance in Gudalur, India, increases access to hospital care. Health Policy Plann. 2010;25:145–154.
   PubMed Web of Science ®Google Scholar
• Tungu M, Amani PJ, Hurtig A-K, Dennis Kiwara A, Mwangu M, Lindholm L, et al. Does health insurance contribute to improved utilization of health care services for the elderly in rural Tanzania? A cross-sectional study. Global Health Action. 2020;13:1841962.
   PubMed Web of Science ®Google Scholar
• Nair D, Tushune K. Reducing health inequalities role of community based health insurance schemes evidence from India and Ethiopia. JBI Evidence Implementation. 2012;10:281.
   Google Scholar
• Acharya A, Vellakkal S, Taylor F, Masset E, Satija A, Burke M, et al. The impact of health insurance schemes for the informal sector in low- and middle-income countries: a systematic review. World Bank Res Obs. 2013;28:236–266.
   Web of Science ®Google Scholar
• van Hees SGM, O’fallon T, Hofker M, Dekker M, Polack S, Banks LM, et al. Leaving no one behind? Social inclusion of health insurance in low- and middle-income countries: a systematic review. Int J Equity Health. 2019;18:134.
   PubMed Web of Science ®Google Scholar
• Haven N, Dobson AE, Yusuf K, Kellermann S, Mutahunga B, Stewart AG, et al. Community-based health insurance increased health care utilization and reduced mortality in children under-5, around bwindi community hospital, uganda between 2015 and 2017. Front Public Health. 2018;6:1–10.
   PubMed Web of Science ®Google Scholar
• Shimeles A. Community based health insurance schemes in Africa: the case of rwanda. Gothenburg, Sweden: University of Gothenburg, Economics; 2010 Aug. Report No.: Working Papers in Economics 463.
   Google Scholar
• Ekman B. Community-based health insurance in low-income countries: a systematic review of the evidence. Health Policy Plan. 2004;19:249–270.
   PubMed Web of Science ®Google Scholar
• Fenny AP, Yates R, Thompson R. Strategies for financing social health insurance schemes for providing universal health care: a comparative analysis of five countries. Global Health Action. 2021;14:1868054.
   PubMed Web of Science ®Google Scholar
• Maqbool M, Dar MA, Rasool S, Gani I, Geer MI. Universal health coverage policy and practice framework in India: a review. Res J Pharm Technol. 2019;12:4045.
   Google Scholar
• Titelman D, Cetrángolo O, Acosta OL. Universal health coverage in Latin American countries: how to improve solidarity-based schemes. Lancet. 2015;385:1359–1363.
   PubMed Web of Science ®Google Scholar
• Nikoloski Z, Cheatley J, Mossialos E. Financial risk protection and unmet healthcare need in Russia. Int J Health Policy Manag. 2022;11:1715–1724.
   PubMedGoogle Scholar
• Bauchet J, Dalal A, Mayasudhakar P, Morduch J, Radermacher R. Can insurers improve healthcare quality? Evidence from a community microinsurance scheme in India. New Delhi, India. New York (NY): Financial Access Initiative, NYU - Robert F. Wagner Graduate School of Public Service; 2010. p. 1.
   Google Scholar
• Michielsen J, Criel B, Devadasan N, Soors W, Wouters E, Meulemans H. Can health insurance improve access to quality care for the Indian poor? Int J Qual Health Care. 2011;23:471–486.
   PubMed Web of Science ®Google Scholar
• Mekonen KD, Tedla WT. Paradoxical consequences of CBHI scheme in rural Ethiopia: enrollees’ perceived preferential treatment to paying clients and concomitant problems. Cogent Social Sci. 2022;8:2057635.
   Web of Science ®Google Scholar
• Bharmal M, Thomas Iii J. Health insurance coverage and health-related quality of life: analysis of 2000 medical expenditure panel survey data. J Health Care Poor Underserved. 2005;16:643–654.
   PubMed Web of Science ®Google Scholar
• Nichol MB, Ning N, Xu Y, Baker J, Curtis R, Koerper MA, et al. Health-related quality of life and health insurance coverage among persons with hemophilia a inhibitors. Blood. 2017;130:4736.
   Web of Science ®Google Scholar
• Transforming our world: The 2030 agenda for sustainable development; 2015.
   Google Scholar
• Kutzin J. Health financing for universal coverage and health system performance: concepts and implications for policy. Bull World Health Organ. 2013;91:602–611.
   PubMed Web of Science ®Google Scholar
• Reich MR, Harris J, Ikegami N, Maeda A, Cashin C, Araujo EC, et al. Moving towards universal health coverage: lessons from 11 country studies. Lancet. 2016;387:811–816.
   PubMed Web of Science ®Google Scholar
• Mathauer I, Vinyals Torres L, Kutzin J, Jakab M, Hanson K. Pooling financial resources for universal health coverage: options for reform. Bull World Health Organ. 2020;98:132–139.
   PubMed Web of Science ®Google Scholar