Does Ethiopia’s CBHI improve use and financial protection?
CBHI members had ~2.09 OPD visits/capita/year and 28–43% lower annual OOP vs non-members, with less catastrophic spending after PSM.
Source
The impact of community-based health insurance on health service utilization and financial risk protection in Ethiopia
What they did
Compared members to non-members in implementing and non-implementing woredas using propensity score matching to reduce selection bias.
What they found
Higher OPD utilization (+0.36 vs non-members in CBHI woredas); substantial OOP reductions; lower catastrophic expenditure risk; authors endorse nationwide CBHI expansion.
The limits
What it doesn't show
Not randomized; residual confounding possible despite PSM; impoverishment patterns partly reflect poorer members’ composition.
Key terms
- CBHI
- Community-based health insurance.
- OOP
- Out-of-pocket health spending.
- Catastrophic health expenditure
- OOP exceeding a share of household spending (here >10%).
- PSM
- Propensity score matching to balance observed covariates.
- Woreda
- District-level administrative unit in Ethiopia.
- OPD visits
- Outpatient department utilization.
Flashcards
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CBHI member households sampled:
Common questions
Member sample?
n=1586.
Member OPD visits/capita/year?
2.09.
OOP reduction?
28–43%.
Analysis for selection?
Propensity score matching.