Assessment of the Effect of Community-Based Health Insurance Scheme on Health-Related Outcomes in Ethiopia: A Systematic Review
Abstract
Background: We aimed to review the effect of community-based health insurance on health-related outcomes in Ethiopia.
Methods: A systematic review was undertaken utilizing a major relevant published literature review from September 2017 to June 15, 2023. PubMed, Scopus, Web of Science, Science Direct, Google Scholar, Semantic Scholar, EMBASE, ProQuest, Hinari, and the Cochrane Library were used to search for relevant literature. Moreover, the Prisma flow model was used to select eligible findings.
Results: Overall, 72% of the articles employed cross-sectional comparative study designs and procedures, and 36% of them employed samples ranging in size from 501 to 1000 participants. Furthermore, 76% were studied using descriptive statistics and logistic regression, whereas fewer utilized a random model, a probity model, or a correlation model. Similarly, 32% of the research used two-stage stratified sampling methods, and around 40% of the data revealed that the scheme increased healthcare utilization services. About 72 % of the reviewed study results showed that the scheme reduced catastrophic health expenditure and increases utilization of healthcare services. And the 20% reviewed studies stated that the CBHI boosts household satisfaction level. Moreover 12% of the reviewed studies stated that, CBHI increased QoL (quality of life).
Conclusion: Most of the studies provide evidence of the positive effect of CBHI in Ethiopia. Mainly, its membership improved the utilization of health services and decreased the incidence of catastrophic health expenditures. Thus, all actors should cooperate to strengthen it to solve the effective attribute of the deprived value of health care and continuity of care delivery system related to the country's new policy.
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2. CSA, ICF (2016). Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA. https://dhsprogram.com/pubs/pdf/FR328/FR328.pdf
3. Geta ET, Wakjira A, Hailu WB (2023). Dis-parities in modern health service utiliza-tion across socio-demographic and economic inequalities among house-holds in Gida Ayana district, Oromia Regional state, Ethiopia: a community-based cross-sectional study. BMC Health Serv Res, 23(1): 597.
4. Mebratie AD, Sparrow R, Yilma Z, et al (2015). Enrollment in Ethiopia’s com-munity-based health insurance scheme. World Dev, 74: 58-76.
5. Feleke S, Mitiku W, Zelelew H, Ashagari T (2015). Ethiopia’s community-based health insurance: a step on the road to universal health coverage. USAID Health Finance and Governance, Abt Associates. Available from: https://pdf.usaid.gov/pdf_docs/PA00KDXT.pdf.
6. Bayked EM, Toleha HN, Kebede SZ, et al (2023). The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic re-view and meta-analysis. Glob Health Ac-tion, 16 (1): 2189764.
7. Gashaw D (2020). Level of household satis-faction in community based health in-surance beneficiaries on medical labor-atory services and its associated factors in selected health centers. Food Sci Qual Manag, 98: 29-35.
8. Nevondwe L, Odeku KO (2014). Financing the national health insurance scheme of South Africa: opportunities and chal-lenges. J Soc Sci, 39 (1): 9-18.
9. Wang W, Temsah G, Mallick L (2017). The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda. Health Policy Plan, 32 (3): 366-375.
10. Fadlallah R, El-Jardali F, Hemadi N, et al (2018). Barriers and facilitators to im-plementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review. Int J Equi-ty Health, 17 (1): 13.
11. Ly MS, Bassoum O, Faye A (2022). Univer-sal health insurance in Africa: a narra-tive review of the literature on institu-tional models. BMJ glob health, 7 (4): e008219.
12. Wang H, Switlick K, Ortiz C, et al (2012). Health insurance handbook: how to make it work. Vol. 219-World Bank Publications.
13. Habiyonizeye Y. Implementing communi-ty-based health insurance schemes: les-sons from the case of Rwanda feeding [Master's thesis]. Akershus University, Norway; 2013.
14. Azmeraw S. Determinants of Community Based Health Insurance Program Im-plementation in Ebinat District, Amhara Regional State, Ethiopia [PhD thesis]. Bahir Dar University, Ethiopia; 2022.
15. Hailie MT, Hassen SL, Temesgen MM (2021). Client satisfaction on community based health insurance scheme and as-sociated factors at Boru Meda Hospital, Northeast, Ethiopia: institutional based cross-sectional study. BMC Health Serv Res, 21 (1): 1287.
16. WHO (2019). Primary health care on the road to universal health coverage: 2019 global monitoring report: executive summary.
17. Likka MH, Handalo DM, Weldsilase YA, Sinkie, SO (2018). The effect of commu-nity-based health insurance schemes on utilization of healthcare services in low- and middle-income countries: a system-atic review protocol of quantitative evi-dence. JBI Database System Rev Implement Rep, 16 (3): 653–661.
18. Kigume R, Maluka S (2021). The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process. BMC Health Serv Res, 21 (1): 646.
19. Kakama AA, Namyalo PK, Basaza RK (2020). Feasibility and desirability of scaling up Community-based Health In-surance (CBHI) in rural communities in Uganda: lessons from Kisiizi Hospital CBHI scheme. BMC Health Serv Res, 20 (1): 662.
20. Demissie B, Gutema NK (2020). Effect of Community-Based Health Insurance on Utilization of Outpatient Health Care Services in Southern Ethiopia: A Com-parative Cross-Sectional Study. Risk Manag Healthc Policy, 13: 141–153.
21. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: An updated guideline for reporting system-atic reviews. Int J Surg, 88: 105906.
22. Mebratie A, Sparrow, R, Debebe, ZY, et al (2014). Dropping out of Ethiopia’s Community Based Health Insurance scheme. ISS Working Paper Series/General Series, 591: 1-40.
23. Lavers T (2019). Social protection in an as-piring ‘developmental state’: The politi-cal drivers of Ethiopia’s PSNP. African Affairs, 118(473):646-671.
24. USAID Health Financing Improvement Program (2022). Annual Performance Report Year 4 (October 1, 2021– Sep-tember 30, 2022). Abt Associates, Rock-ville MD.
25. WHO (2020). Community based health insurance. Geneva (CH): World Health Organization; updated 2020.
26. FMoH E (2017). Ethiopian health accounts household health service utilization and expenditure survey 2015/2016. Federal Democratic Republic of Ethiopia Ministry of Health, Addis Ababa.
27. Woldemichael A, Takian A, Sari AA, Olyaeemanesh A (2019). Availability and inequality in accessibility of health cen-ter-based primary healthcare in Ethio-pia. PLoS One, 14 (3): e0213896.
28. Moyehodie YA, Mulugeta SS, Amare YS (2022). The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia. PLoS One, 17 (10): e0275896.
29. Mekonen AM, Gebregziabher MG, Teferra AS (2018). The effect of community based health insurance on catastrophic health expenditure in Northeast Ethio-pia: A cross sectional study. PLoS One, 13 (10): e0205972.
30. Kassa AM (2023). In Ethiopia’s Kutaber dis-trict, does community-based health in-surance protect households from cata-strophic health-care costs? A communi-ty-based comparative cross-sectional study. PLoS One, 18 (2): e0281476.
31. Jembere MY (2018). 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 Te-huledere district, Northeast Ethiopia. Fam Med Med Sci Res, 7:2.
32. Atnafu DD, Tilahun H, Alemu YM (2018). Community-based health insurance and healthcare service utilization, North-West, Ethiopia: a comparative, cross-sectional study. BMJ Open, 8 (8): e019613.
33. Alemayehu YK, Dessie E, Medhin G, et al (2023). The impact of community-based health insurance on health service utili-zation and financial risk protection in Ethiopia. BMC Health Serv Res, 23 (1): 67.
34. Workneh SG, Biks GA, Woreta SA (2017). Community-based health insurance and communities’ scheme requirement com-pliance in Thehuldere district, northeast Ethiopia: cross-sectional community-based study. Clinicoecon Outcomes Res, 9: 353-359.
35. Shigute Z, Mebratie AD, Sparrow R, et al (2020). The effect of Ethiopia’s commu-nity-based health insurance scheme on revenues and quality of care. Int J Envi-ron Res Public Health, 17 (22): 8558.
36. Mussa EC, Otchere F, Vinci V, et al (2021). Linking poverty-targeted social protec-tion and Community Based Health In-surance in Ethiopia: Enrolment, linkag-es, and gaps. Soc Sci Med, 286: 114312.
37. Mitiku KK, Geberetsadik SM (2019). Household satisfaction with community-based health insurance scheme and as-sociated factors in piloted Sheko dis-trict; Southwest Ethiopia. PLoS One, 14 (5): e0216411.
38. Girmay AM, Reta MT (2022). Community‐based health insurance service utiliza-tion and associated factors in Addis Ab-aba, Ethiopia. Public Health Challenges, 1 (3): e18.
39. Fufa G, Ermeko T, Mohammed AY, Lette A (2021). Assessing factors associated with poor community based health in-surance client satisfaction level with public health care services in Negele Arsi Woreda Health Centers, West Arsi Zone Ethiopia. Arch Med, (13)5: 21.
40. Abdilwohab MG, Abebo ZH, Godana W, et al (2021). Factors affecting enrollment status of households for community based health insurance in a resource-limited peripheral area in Southern Ethiopia. Mixed method. PLoS One, 16 (1): e0245952.
41. Asfaw DM, Shifaw SM, Belete AA, Aychi-luhm SB (2022). The impact of commu-nity-based health insurance on house-hold's welfare in Chilga district, Amha-ra, Ethiopia. Front Public Health, 10: 868274.
42. Addise T, Alemayehu T, Assefa N, Erkalo D (2021). The magnitude of satisfaction and associated factors among house-hold heads who visited health facilities with community-based health insurance scheme in Anilemo District, Hadiya Zone, southern Ethiopia. Risk Manag Healthc Policy, 14: 145-154.
43. Bantie GM, Woya AA, Zewdie BM (2020). Community-based health insurance and associated factors in North-Western Ethiopia. The case of Bahir Dar city. Int J Gen Med, 13: 1207-1217.
44. Kaso AW, Yohanis Y, Debela BG, Hareru HE (2022). Community-based health in-surance membership renewal rate and associated factors among households in Gedeo zone, southern Ethiopia. J Envi-ron Public Health, 2022:8479834.
45. Mula AK, Mao W, Bharali I, et al (2022). Scaling up community-based health in-surance in Ethiopia: a qualitative study of the benefits and challenges. BMC Health Serv Res, 22 (1): 473.
46. Jembere MY (2018). The role of communi-ty based health insurance scheme on fi-nancial protection and healthcare seek-ing behavior of households in Te-huledere District, Northeast Ethiopia. International Journal of Health Economics and Policy, 3 (2): 13-19.
47. Christian K. Public health project and community based health insurance performance in Rwanda A case study of public health project in Karongi district [PhD thesis]: Mount Kenya University, Kenya; 2017.
48. Geferso AT, Sharo SB (2022). Community-based health insurance utilization and its associated factors among rural households in Akaki District, Oromia, Ethiopia. Adv Public Health, 1-12.
49. Mirach TH, Demissie GD, Biks GA (2019). Determinants of community-based health insurance implementation in west Gojjam zone, Northwest Ethiopia: a community based cross sectional study design. BMC Health Serv Res, 19: 544.
50. Atinafu W. Practices and challenge on community based health insurance: the case of Basketo special woreda [PhD thesis]: Haremaya University, Ethiopia; 2022.
51. Moyehodie YA, Fenta SM, Mulugeta SS, et al (2022). Factors Associated with Com-munity Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study. Health Serv Insights, 15: 11786329221096065.
52. Shigute Z, Strupat C, Burchi F, et al (2020). Linking social protection schemes: the joint effects of a public works and a health insurance programme in Ethio-pia. J Dev Stud, 56 (2): 431-448.
53. Mussa EC, Agegnehu D, Nshakira-Rukundo E (2022). Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia. SSM Popul Health, 17: 101030.
54. Badacho AS, Tushune K, Ejigu Y, Berheto TM (2016). Household satisfaction with a community-based health insurance scheme in Ethiopia. BMC Res Notes, 9: 424.
55. Shigute Z, Mebratie AD, Sparrow R, et al (2017). Uptake of health insurance and the productive safety net program in ru-ral Ethiopia. Soc Sci Med, 176: 133-141.
56. Bayked EM, Toleha HN, Kebede SZ, et al (2023). The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic re-view and meta-analysis. Glob Health Ac-tion, 16 (1): 2189764.
57. Tilahun H, Atnafu DD, Asrade G, et al (2018). Factors for healthcare utilization and effect of mutual health insurance on healthcare utilization in rural com-munities of South Achefer Woreda, North West Ethiopia. Health Econ Rev, 8: 15.
58. Ethiopia F (2015). Health Sector Transfor-mation Plan (HSTP): 2015/16-− 2019/20, Addis Ababa. Available from: https://ephi.gov.et/wp-content/uploads/2023/01/2.-Ethiopia-Health-Sector-Transformation-Plan-I-2015-2020-Endline-Review.pdf
2. CSA, ICF (2016). Ethiopia Demographic and Health Survey 2016. Addis Ababa, Ethiopia, and Rockville, Maryland, USA. https://dhsprogram.com/pubs/pdf/FR328/FR328.pdf
3. Geta ET, Wakjira A, Hailu WB (2023). Dis-parities in modern health service utiliza-tion across socio-demographic and economic inequalities among house-holds in Gida Ayana district, Oromia Regional state, Ethiopia: a community-based cross-sectional study. BMC Health Serv Res, 23(1): 597.
4. Mebratie AD, Sparrow R, Yilma Z, et al (2015). Enrollment in Ethiopia’s com-munity-based health insurance scheme. World Dev, 74: 58-76.
5. Feleke S, Mitiku W, Zelelew H, Ashagari T (2015). Ethiopia’s community-based health insurance: a step on the road to universal health coverage. USAID Health Finance and Governance, Abt Associates. Available from: https://pdf.usaid.gov/pdf_docs/PA00KDXT.pdf.
6. Bayked EM, Toleha HN, Kebede SZ, et al (2023). The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic re-view and meta-analysis. Glob Health Ac-tion, 16 (1): 2189764.
7. Gashaw D (2020). Level of household satis-faction in community based health in-surance beneficiaries on medical labor-atory services and its associated factors in selected health centers. Food Sci Qual Manag, 98: 29-35.
8. Nevondwe L, Odeku KO (2014). Financing the national health insurance scheme of South Africa: opportunities and chal-lenges. J Soc Sci, 39 (1): 9-18.
9. Wang W, Temsah G, Mallick L (2017). The impact of health insurance on maternal health care utilization: evidence from Ghana, Indonesia and Rwanda. Health Policy Plan, 32 (3): 366-375.
10. Fadlallah R, El-Jardali F, Hemadi N, et al (2018). Barriers and facilitators to im-plementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review. Int J Equi-ty Health, 17 (1): 13.
11. Ly MS, Bassoum O, Faye A (2022). Univer-sal health insurance in Africa: a narra-tive review of the literature on institu-tional models. BMJ glob health, 7 (4): e008219.
12. Wang H, Switlick K, Ortiz C, et al (2012). Health insurance handbook: how to make it work. Vol. 219-World Bank Publications.
13. Habiyonizeye Y. Implementing communi-ty-based health insurance schemes: les-sons from the case of Rwanda feeding [Master's thesis]. Akershus University, Norway; 2013.
14. Azmeraw S. Determinants of Community Based Health Insurance Program Im-plementation in Ebinat District, Amhara Regional State, Ethiopia [PhD thesis]. Bahir Dar University, Ethiopia; 2022.
15. Hailie MT, Hassen SL, Temesgen MM (2021). Client satisfaction on community based health insurance scheme and as-sociated factors at Boru Meda Hospital, Northeast, Ethiopia: institutional based cross-sectional study. BMC Health Serv Res, 21 (1): 1287.
16. WHO (2019). Primary health care on the road to universal health coverage: 2019 global monitoring report: executive summary.
17. Likka MH, Handalo DM, Weldsilase YA, Sinkie, SO (2018). The effect of commu-nity-based health insurance schemes on utilization of healthcare services in low- and middle-income countries: a system-atic review protocol of quantitative evi-dence. JBI Database System Rev Implement Rep, 16 (3): 653–661.
18. Kigume R, Maluka S (2021). The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process. BMC Health Serv Res, 21 (1): 646.
19. Kakama AA, Namyalo PK, Basaza RK (2020). Feasibility and desirability of scaling up Community-based Health In-surance (CBHI) in rural communities in Uganda: lessons from Kisiizi Hospital CBHI scheme. BMC Health Serv Res, 20 (1): 662.
20. Demissie B, Gutema NK (2020). Effect of Community-Based Health Insurance on Utilization of Outpatient Health Care Services in Southern Ethiopia: A Com-parative Cross-Sectional Study. Risk Manag Healthc Policy, 13: 141–153.
21. Page MJ, McKenzie JE, Bossuyt PM, et al (2021). The PRISMA 2020 statement: An updated guideline for reporting system-atic reviews. Int J Surg, 88: 105906.
22. Mebratie A, Sparrow, R, Debebe, ZY, et al (2014). Dropping out of Ethiopia’s Community Based Health Insurance scheme. ISS Working Paper Series/General Series, 591: 1-40.
23. Lavers T (2019). Social protection in an as-piring ‘developmental state’: The politi-cal drivers of Ethiopia’s PSNP. African Affairs, 118(473):646-671.
24. USAID Health Financing Improvement Program (2022). Annual Performance Report Year 4 (October 1, 2021– Sep-tember 30, 2022). Abt Associates, Rock-ville MD.
25. WHO (2020). Community based health insurance. Geneva (CH): World Health Organization; updated 2020.
26. FMoH E (2017). Ethiopian health accounts household health service utilization and expenditure survey 2015/2016. Federal Democratic Republic of Ethiopia Ministry of Health, Addis Ababa.
27. Woldemichael A, Takian A, Sari AA, Olyaeemanesh A (2019). Availability and inequality in accessibility of health cen-ter-based primary healthcare in Ethio-pia. PLoS One, 14 (3): e0213896.
28. Moyehodie YA, Mulugeta SS, Amare YS (2022). The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia. PLoS One, 17 (10): e0275896.
29. Mekonen AM, Gebregziabher MG, Teferra AS (2018). The effect of community based health insurance on catastrophic health expenditure in Northeast Ethio-pia: A cross sectional study. PLoS One, 13 (10): e0205972.
30. Kassa AM (2023). In Ethiopia’s Kutaber dis-trict, does community-based health in-surance protect households from cata-strophic health-care costs? A communi-ty-based comparative cross-sectional study. PLoS One, 18 (2): e0281476.
31. Jembere MY (2018). 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 Te-huledere district, Northeast Ethiopia. Fam Med Med Sci Res, 7:2.
32. Atnafu DD, Tilahun H, Alemu YM (2018). Community-based health insurance and healthcare service utilization, North-West, Ethiopia: a comparative, cross-sectional study. BMJ Open, 8 (8): e019613.
33. Alemayehu YK, Dessie E, Medhin G, et al (2023). The impact of community-based health insurance on health service utili-zation and financial risk protection in Ethiopia. BMC Health Serv Res, 23 (1): 67.
34. Workneh SG, Biks GA, Woreta SA (2017). Community-based health insurance and communities’ scheme requirement com-pliance in Thehuldere district, northeast Ethiopia: cross-sectional community-based study. Clinicoecon Outcomes Res, 9: 353-359.
35. Shigute Z, Mebratie AD, Sparrow R, et al (2020). The effect of Ethiopia’s commu-nity-based health insurance scheme on revenues and quality of care. Int J Envi-ron Res Public Health, 17 (22): 8558.
36. Mussa EC, Otchere F, Vinci V, et al (2021). Linking poverty-targeted social protec-tion and Community Based Health In-surance in Ethiopia: Enrolment, linkag-es, and gaps. Soc Sci Med, 286: 114312.
37. Mitiku KK, Geberetsadik SM (2019). Household satisfaction with community-based health insurance scheme and as-sociated factors in piloted Sheko dis-trict; Southwest Ethiopia. PLoS One, 14 (5): e0216411.
38. Girmay AM, Reta MT (2022). Community‐based health insurance service utiliza-tion and associated factors in Addis Ab-aba, Ethiopia. Public Health Challenges, 1 (3): e18.
39. Fufa G, Ermeko T, Mohammed AY, Lette A (2021). Assessing factors associated with poor community based health in-surance client satisfaction level with public health care services in Negele Arsi Woreda Health Centers, West Arsi Zone Ethiopia. Arch Med, (13)5: 21.
40. Abdilwohab MG, Abebo ZH, Godana W, et al (2021). Factors affecting enrollment status of households for community based health insurance in a resource-limited peripheral area in Southern Ethiopia. Mixed method. PLoS One, 16 (1): e0245952.
41. Asfaw DM, Shifaw SM, Belete AA, Aychi-luhm SB (2022). The impact of commu-nity-based health insurance on house-hold's welfare in Chilga district, Amha-ra, Ethiopia. Front Public Health, 10: 868274.
42. Addise T, Alemayehu T, Assefa N, Erkalo D (2021). The magnitude of satisfaction and associated factors among house-hold heads who visited health facilities with community-based health insurance scheme in Anilemo District, Hadiya Zone, southern Ethiopia. Risk Manag Healthc Policy, 14: 145-154.
43. Bantie GM, Woya AA, Zewdie BM (2020). Community-based health insurance and associated factors in North-Western Ethiopia. The case of Bahir Dar city. Int J Gen Med, 13: 1207-1217.
44. Kaso AW, Yohanis Y, Debela BG, Hareru HE (2022). Community-based health in-surance membership renewal rate and associated factors among households in Gedeo zone, southern Ethiopia. J Envi-ron Public Health, 2022:8479834.
45. Mula AK, Mao W, Bharali I, et al (2022). Scaling up community-based health in-surance in Ethiopia: a qualitative study of the benefits and challenges. BMC Health Serv Res, 22 (1): 473.
46. Jembere MY (2018). The role of communi-ty based health insurance scheme on fi-nancial protection and healthcare seek-ing behavior of households in Te-huledere District, Northeast Ethiopia. International Journal of Health Economics and Policy, 3 (2): 13-19.
47. Christian K. Public health project and community based health insurance performance in Rwanda A case study of public health project in Karongi district [PhD thesis]: Mount Kenya University, Kenya; 2017.
48. Geferso AT, Sharo SB (2022). Community-based health insurance utilization and its associated factors among rural households in Akaki District, Oromia, Ethiopia. Adv Public Health, 1-12.
49. Mirach TH, Demissie GD, Biks GA (2019). Determinants of community-based health insurance implementation in west Gojjam zone, Northwest Ethiopia: a community based cross sectional study design. BMC Health Serv Res, 19: 544.
50. Atinafu W. Practices and challenge on community based health insurance: the case of Basketo special woreda [PhD thesis]: Haremaya University, Ethiopia; 2022.
51. Moyehodie YA, Fenta SM, Mulugeta SS, et al (2022). Factors Associated with Com-munity Based Health Insurance Healthcare Service Utilization of Households in South Gondar Zone, Amhara, Ethiopia. A Community-Based Cross-Sectional Study. Health Serv Insights, 15: 11786329221096065.
52. Shigute Z, Strupat C, Burchi F, et al (2020). Linking social protection schemes: the joint effects of a public works and a health insurance programme in Ethio-pia. J Dev Stud, 56 (2): 431-448.
53. Mussa EC, Agegnehu D, Nshakira-Rukundo E (2022). Impact of conditional cash transfers on enrolment in community-based health insurance among female-headed households in south Gondar zone, Amhara region, Ethiopia. SSM Popul Health, 17: 101030.
54. Badacho AS, Tushune K, Ejigu Y, Berheto TM (2016). Household satisfaction with a community-based health insurance scheme in Ethiopia. BMC Res Notes, 9: 424.
55. Shigute Z, Mebratie AD, Sparrow R, et al (2017). Uptake of health insurance and the productive safety net program in ru-ral Ethiopia. Soc Sci Med, 176: 133-141.
56. Bayked EM, Toleha HN, Kebede SZ, et al (2023). The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic re-view and meta-analysis. Glob Health Ac-tion, 16 (1): 2189764.
57. Tilahun H, Atnafu DD, Asrade G, et al (2018). Factors for healthcare utilization and effect of mutual health insurance on healthcare utilization in rural com-munities of South Achefer Woreda, North West Ethiopia. Health Econ Rev, 8: 15.
58. Ethiopia F (2015). Health Sector Transfor-mation Plan (HSTP): 2015/16-− 2019/20, Addis Ababa. Available from: https://ephi.gov.et/wp-content/uploads/2023/01/2.-Ethiopia-Health-Sector-Transformation-Plan-I-2015-2020-Endline-Review.pdf
| Files | ||
| Issue | Vol 53 No 10 (2024) | |
| Section | Review Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v53i10.16701 | |
| Keywords | ||
| Community-based health insurance scheme Health-related outcomes Systematic review Ethiopia | ||
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How to Cite
1.
Yihdego AG, Tajvar M, Akbari Sari A. Assessment of the Effect of Community-Based Health Insurance Scheme on Health-Related Outcomes in Ethiopia: A Systematic Review. Iran J Public Health. 2024;53(10):2239-2250.
