African Journal of Economic Review

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Community Based Health Insurance Schemes and Protection of the Rural Poor: Empirical evidence from Tanzania

RR Macha


The objectives of this study are two folds: firstly to explore the magnitude of catastrophic expenditure, and secondly to determine its contributing factor,s including the protective impact of the voluntary  community based health insurance schemes in Tanzania. The study covered 274 respondents. Study  findings have shown that the estimated poverty line was Tsh.35,064.6 (US$21.25). Of the sampled  respondents, 30.3% experienced catastrophic expenditure in the range of 10-20% of their capacity to pay, and 26.6% of the insured respondents experienced catastrophic expenditure. The average  catastrophic expenditure for the sample is 26.64%. We used logistic regression to predict the factors  influencing catastrophic health expenditure. Our results have shown that households with heads  involved in social organisations or networks were more protected against catastrophic health  expenditures. On the other hand, households headed by a female and involved in farming, were more  likely to experience catastrophic health expenditure. Further, in households whose heads had low  levels of education and households having members with recurring or chronic illness were more likely  to experience catastrophic health expenditure. While households with insurance cover were more likely to be protected from the risk of catastrophic health expenditure compared with those not covered by  insurance schemes, there are no significant differences in terms of lessened catastrophic expenditure  that poor participants and non-participants enjoyed from their participation in CHF.

Keywords: catastrophic expenditure, social protection, community based health insurance, community health fund.

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