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Feasibility of community-based health insurance in rural tropical Ecuador
Östergötlands Läns Landsting, Local Health Care Services in Central Östergötland, Primary Health Care Centres.
Karolinska Institute.
University of Trier.
Pontificia University Catolica Ecuador.
2011 (English)In: REVISTA PANAMERICANA DE SALUD PUBLICA-PAN AMERICAN JOURNAL OF PUBLIC HEALTH, ISSN 1020-4989, Vol. 29, no 3, 177-184 p.Article in journal (Refereed) Published
Abstract [en]

Objective. The main objective of this study was to assess peoples willingness to join a community-based health insurance (CHI) model in El Paramo, a rural area in Ecuador, and to determine factors influencing this willingness. A second objective was to identify peoples understanding and attitudes toward the presented CHI model. Methods. A cross-sectional survey was carried out using a structured questionnaire. Of an estimated 829 households, 210 were randomly selected by two-stage cluster sampling. Attitudes toward the scheme were assessed. Information on factors possibly influencing willingness to join was collected and related to the willingness to join. To gain an insight into a respondents possible ability to pay, health care expenditure on the last illness episode was assessed. Feasibility was defined as at least 50% of household heads willing to join the scheme. Results. Willingness to join the CHI model for US$30 per year was 69.3%. With affiliation, 92.2% of interviewees stated that they would visit the local health facility more often. Willingness to join was found to be negatively associated with education. Other variables showed no significant association with willingness to join. The study showed a positive attitude toward the CHI scheme. Substantial health care expenditures on the last illness episode were documented. Conclusions. The investigation concludes that CHI in the study region is feasible. However, enrollments are likely to be lower than the stated willingness to join. Still, a CHI scheme should present an interesting financing alternative in rural areas where services are scarce and difficult to sustain.

Place, publisher, year, edition, pages
Organizacion Panamericana de la Salud , 2011. Vol. 29, no 3, 177-184 p.
Keyword [en]
Health insurance, feasibility studies, primary health care, Ecuador
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-68013ISI: 000289364100005OAI: diva2:415254
Available from: 2011-05-06 Created: 2011-05-06 Last updated: 2011-05-06

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