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Household perceptions towards a redistributive policy across health insurance funds in Tanzania
BACKGROUND: The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is groun...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371804/ https://www.ncbi.nlm.nih.gov/pubmed/25886007 http://dx.doi.org/10.1186/s12913-015-0761-z |
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author | Chomi, Eunice N Mujinja, Phares GM Hansen, Kristian Kiwara, Angwara D Enemark, Ulrika |
author_facet | Chomi, Eunice N Mujinja, Phares GM Hansen, Kristian Kiwara, Angwara D Enemark, Ulrika |
author_sort | Chomi, Eunice N |
collection | PubMed |
description | BACKGROUND: The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is grounded on the level of solidarity within the country. The aim of this paper is to analyse the perceptions of CHF, NHIF and non-member households towards cross-subsidisation of the poor as an indication of the level of solidarity and acceptance of redistributive mechanisms. METHODS: This study analyses data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used to identify factors associated with support for cross-subsidisation of the poor. RESULTS: Compared to CHF and NHIF households, non-member households expressed the highest support for subsidised CHF membership for the poor. The odds of expressing support for subsidised CHF membership are higher for NHIF households and non-member households, households that are wealthier, whose household heads have lower education levels, and have sick members. The majority of households support a partial rather than fully subsidised CHF membership for the poor and there were no significant differences by membership status. The odds of expressing willingness to contribute towards subsidised CHF membership are higher for households that are wealthier, with young household heads and have confidence in scheme management. CONCLUSION: The majority may support a redistributive policy, but there are indications that this support and willingness to contribute to its achievement are influenced by the perceived benefits, amount of subsidy considered, and trust in scheme management. These present important issues for consideration when designing redistributive policies. |
format | Online Article Text |
id | pubmed-4371804 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-43718042015-03-25 Household perceptions towards a redistributive policy across health insurance funds in Tanzania Chomi, Eunice N Mujinja, Phares GM Hansen, Kristian Kiwara, Angwara D Enemark, Ulrika BMC Health Serv Res Research Article BACKGROUND: The Tanzanian health insurance system comprises multiple health insurance funds targeting different population groups but which operate in parallel, with no mechanisms for redistribution across the funds. Establishing such redistributive mechanisms requires public support, which is grounded on the level of solidarity within the country. The aim of this paper is to analyse the perceptions of CHF, NHIF and non-member households towards cross-subsidisation of the poor as an indication of the level of solidarity and acceptance of redistributive mechanisms. METHODS: This study analyses data collected from a survey of 695 households relating to perceptions of household heads towards cross-subsidisation of the poor to enable them to access health services. Kruskal-Wallis test is used to compare perceptions by membership status. Generalized ordinal logistic regression models are used to identify factors associated with support for cross-subsidisation of the poor. RESULTS: Compared to CHF and NHIF households, non-member households expressed the highest support for subsidised CHF membership for the poor. The odds of expressing support for subsidised CHF membership are higher for NHIF households and non-member households, households that are wealthier, whose household heads have lower education levels, and have sick members. The majority of households support a partial rather than fully subsidised CHF membership for the poor and there were no significant differences by membership status. The odds of expressing willingness to contribute towards subsidised CHF membership are higher for households that are wealthier, with young household heads and have confidence in scheme management. CONCLUSION: The majority may support a redistributive policy, but there are indications that this support and willingness to contribute to its achievement are influenced by the perceived benefits, amount of subsidy considered, and trust in scheme management. These present important issues for consideration when designing redistributive policies. BioMed Central 2015-03-15 /pmc/articles/PMC4371804/ /pubmed/25886007 http://dx.doi.org/10.1186/s12913-015-0761-z Text en © Chomi et al.; licensee BioMed Central. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Chomi, Eunice N Mujinja, Phares GM Hansen, Kristian Kiwara, Angwara D Enemark, Ulrika Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title | Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title_full | Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title_fullStr | Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title_full_unstemmed | Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title_short | Household perceptions towards a redistributive policy across health insurance funds in Tanzania |
title_sort | household perceptions towards a redistributive policy across health insurance funds in tanzania |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4371804/ https://www.ncbi.nlm.nih.gov/pubmed/25886007 http://dx.doi.org/10.1186/s12913-015-0761-z |
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