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Trust in micro-health insurance: an exploratory study in Rwanda

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  • Schneider, Pia

Abstract

Micro-health insurance (MHI) has been proposed as an alternative to user fees to improve access to medical care without the threat of financial impoverishment. To enrol in health insurance and pay a premium, consumers should be able to trust that insurers use their funds to reimburse providers who will deliver quality care when needed. In 1998, shortly after the re-introduction of user fees, the Rwandan Ministry of Health in close collaboration with the local population developed and implemented MHI in three districts. Member benefits cover preventive and curative care in health centres and ambulance transport to the district hospital where a limited package of services is also covered by MHI. This paper examines trust-building structures and practices in MHI in Rwanda. It is an exploratory, descriptive analysis using information collected from focus groups. Findings suggest that MHI managers, providers and policy-makers need to think systematically about a wide range of initiatives that enhance trust and caring, and to design trust-building structures and practices in the consumer-insurance-provider arrangement.

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  • Schneider, Pia, 2005. "Trust in micro-health insurance: an exploratory study in Rwanda," Social Science & Medicine, Elsevier, vol. 61(7), pages 1430-1438, October.
    • Handle: RePEc:eee:socmed:v:61:y:2005:i:7:p:1430-1438
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    1. Besley, Timothy & Coate, Stephen & Loury, Glenn, 1993. "The Economics of Rotating Savings and Credit Associations," American Economic Review, American Economic Association, vol. 83(4), pages 792-810, September.
    2. Mr. Francis Fukuyama, 2000. "Social Capital and Civil Society," IMF Working Papers 2000/074, International Monetary Fund.
    3. Besley, Timothy & Hall, John & Preston, Ian, 1999. "The demand for private health insurance: do waiting lists matter?," Journal of Public Economics, Elsevier, vol. 72(2), pages 155-181, May.
    4. Besley, Timothy, 1995. "Savings, credit and insurance," Handbook of Development Economics, in: Hollis Chenery & T.N. Srinivasan (ed.), Handbook of Development Economics, edition 1, volume 3, chapter 36, pages 2123-2207, Elsevier.
    5. Gilson, Lucy, 2003. "Trust and the development of health care as a social institution," Social Science & Medicine, Elsevier, vol. 56(7), pages 1453-1468, April.
    6. Criel, Bart & Waelkens, Maria Pia, 2003. "Declining subscriptions to the Maliando Mutual Health Organisation in Guinea-Conakry (West Africa): what is going wrong?," Social Science & Medicine, Elsevier, vol. 57(7), pages 1205-1219, October.
    7. Coleman, James S, 1984. "Introducing Social Structure into Economic Analysis," American Economic Review, American Economic Association, vol. 74(2), pages 84-88, May.
    8. Randall P. Ellis & Thomas G. McGuire, 1993. "Supply-Side and Demand-Side Cost Sharing in Health Care," Journal of Economic Perspectives, American Economic Association, vol. 7(4), pages 135-151, Fall.
    9. Ahern, Melissa M. & Hendryx, Michael S., 2003. "Social capital and trust in providers," Social Science & Medicine, Elsevier, vol. 57(7), pages 1195-1203, October.
    10. Jonathan Morduch, 1995. "Income Smoothing and Consumption Smoothing," Journal of Economic Perspectives, American Economic Association, vol. 9(3), pages 103-114, Summer.
    11. Straten, G. F. M. & Friele, R. D. & Groenewegen, P. P., 2002. "Public trust in Dutch health care," Social Science & Medicine, Elsevier, vol. 55(2), pages 227-234, July.
    Full references (including those not matched with items on IDEAS)

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    Cited by:

    1. David Mark Dror, 2018. "What Factors Affect Voluntary Uptake of Community-based Health Insurance Schemes in Lowand Middle-Income Countries? A Systematic Review and Meta-Analysis," World Scientific Book Chapters, in: Financing Micro Health Insurance Theory, Methods and Evidence, chapter 14, pages 271-306, World Scientific Publishing Co. Pte. Ltd..
    2. Clara Delavallade, 2014. "Quality Healthcare and Health Insurance Retention: Evidence from a Randomized Experiment in the Kolkata Slums," Working Papers id:5916, eSocialSciences.
    3. Hsiao, William C. & Yip, Winnie, 2024. "Financing and provision of healthcare for two billion people in low-income nations: Is the cooperative healthcare model a solution?," Social Science & Medicine, Elsevier, vol. 345(C).
    4. Thomas Rouyard & Yukichi Mano & Bocar Mamadou Daff & Serigne Diouf & Khadidiatou Fall Dia & Laetitia Duval & Josselin Thuilliez & Ryota Nakamura, 2022. "Operational and Structural Factors Influencing Enrolment in Community-Based Health Insurance Schemes: An Observational Study Using 12 Waves of Nationwide Panel Data from Senegal," Post-Print halshs-03641124, HAL.
    5. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2019. "Can information increase the understanding and uptake of insurance? Lessons from a randomized experiment in rural Burkina Faso," Social Science & Medicine, Elsevier, vol. 220(C), pages 102-111.
    6. Francisco Galarza & Ingo Outes Leonb, 2016. "Do you want some cash-back? Assessing the demand for a no-claim rebate life-insurance product," Working Papers 16-04, Centro de Investigación, Universidad del Pacífico.
    7. Ridde, Valery & Haddad, Slim & Yacoubou, Moussa & Yacoubou, Ismaelou, 2010. "Exploratory study of the impacts of Mutual Health Organizations on social dynamics in Benin," Social Science & Medicine, Elsevier, vol. 71(3), pages 467-474, August.
    8. Saksena, Priyanka & Antunes, Adélio Fernandes & Xu, Ke & Musango, Laurent & Carrin, Guy, 2011. "Mutual health insurance in Rwanda: Evidence on access to care and financial risk protection," Health Policy, Elsevier, vol. 99(3), pages 203-209, March.
    9. Osei Afriyie, Doris & Masiye, Felix & Tediosi, Fabrizio & Fink, Günther, 2023. "Confidence in the health system and health insurance enrollment among the informal sector population in Lusaka, Zambia," Social Science & Medicine, Elsevier, vol. 321(C).
    10. Lin, Wanchuan & Liu, Yiming & Meng, Juanjuan, 2014. "The crowding-out effect of formal insurance on informal risk sharing: An experimental study," Games and Economic Behavior, Elsevier, vol. 86(C), pages 184-211.
    11. Mladovsky, Philipa, 2014. "Why do people drop out of community-based health insurance? Findings from an exploratory household survey in Senegal," Social Science & Medicine, Elsevier, vol. 107(C), pages 78-88.
    12. Juliette Alenda-Demoutiez & Bruno Boidin, 2019. "Community-based mutual health organisations in Senegal: a specific form of social and solidarity economy?," Post-Print hal-02400072, HAL.
    13. Petro G. Nzowa & Felix A. Nandonde & Somo M. L. Seimu, 2023. "Mediation effect of trust on willingness to pay for health insurance among co-operative members in Tanzania," Future Business Journal, Springer, vol. 9(1), pages 1-15, December.
    14. Arun, Thankom & Bendig, Mirko & Arun, Shoba, 2012. "Bequest Motives and Determinants of Micro Life Insurance in Sri Lanka," World Development, Elsevier, vol. 40(8), pages 1700-1711.
    15. Attakora-Amaniampong Elvis & Salakpi Andrews & Quansah Joseph Y.D., 2015. "Abysmal Insurance Patronage for Residential Properties in Ghana," International Journal of Academic Research in Business and Social Sciences, Human Resource Management Academic Research Society, International Journal of Academic Research in Business and Social Sciences, vol. 5(9), pages 125-144, September.
    16. Lin, Wanchuan & Meng, Juanjuan & Weng, Xi, 2020. "Formal insurance and informal risk sharing dynamics," Journal of Economic Behavior & Organization, Elsevier, vol. 180(C), pages 837-863.
    17. Agier, Isabelle & Ly, Antarou & Kadio, Kadidiatou & Kouanda, Seni & Ridde, Valéry, 2016. "Endorsement of universal health coverage financial principles in Burkina Faso," Social Science & Medicine, Elsevier, vol. 151(C), pages 157-166.
    18. Jehu-Appiah, Caroline & Aryeetey, Genevieve & Spaan, Ernst & de Hoop, Thomas & Agyepong, Irene & Baltussen, Rob, 2011. "Equity aspects of the National Health Insurance Scheme in Ghana: Who is enrolling, who is not and why?," Social Science & Medicine, Elsevier, vol. 72(2), pages 157-165, January.
    19. Bocoum, Fadima & Grimm, Michael & Hartwig, Renate & Zongo, Nathalie, 2017. "Nudging Households to Take Up Health Insurance: Evidence from a Randomized Experiment in Burkina Faso," IZA Discussion Papers 10744, Institute of Labor Economics (IZA).
    20. Binagwaho, Agnes & Hartwig, Renate & Ingeri, Denyse & Makaka, Andrew, 2012. "Mutual health insurance and its contribution to improving child health in Rwanda," Passauer Diskussionspapiere, Volkswirtschaftliche Reihe V-66-12, University of Passau, Faculty of Business and Economics.
    21. Elder, Sara D. & Zerriffi, Hisham & Le Billon, Philippe, 2012. "Effects of Fair Trade Certification on Social Capital: The Case of Rwandan Coffee Producers," World Development, Elsevier, vol. 40(11), pages 2355-2367.
    22. Mladovsky, Philipa & Mossialos, Elias, 2008. "A Conceptual Framework for Community-Based Health Insurance in Low-Income Countries: Social Capital and Economic Development," World Development, Elsevier, vol. 36(4), pages 590-607, April.
    23. Mladovsky, Philipa, 2014. "Why do people drop out of community-based health insurance?: findings from an exploratory household survey in Senegal," LSE Research Online Documents on Economics 55820, London School of Economics and Political Science, LSE Library.

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