Measuring the Impact of Micro-Health Insurance on Healthcare Utilization: A Bayesian Potential Outcomes Approach



One of the primary reasons for low healthcare utilisation rates in low-income countries is lack of affordable health insurance coverage. In recent years, Community-Based Health Insurance programmes are widely implemented across developing countries aimed at increasing healthcare utilisation and providing financial protection. 
This study investigates the causal effects of the programme on utilisation of healthcare services in Rwanda using non-randomised household survey data. In a Bayesian potential outcomes framework with Markov Chain Monte Carlo simulation techniques, it addresses issues of selection bias on observable and unobservable dimensions. In addition, it addresses heterogeneity by estimating treatment effects at the individual-level. It finds that Community-Based Health Insurance schemes significantly increase the likelihood of utilising medical consultation and screening services but not utilisation of drugs. We also find considerable heterogeneity in treatment effects with married women and under-five children benefiting the most. 




Andinet Woldemichael and Abebe Shimeles

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African Development Bank Group

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