Community-based health insurance and health outcomes in Sub-saharan Africa: evidence from a systematic review

Abstract

The poor in Sub-Saharan Africa finds it difficult to access quality healthcare because of their socioeconomic status. Community-Based Health Insurance (CBHI) has come to the rescue of the poor in healthcare accessibility and affordability. This review evaluates the impact of CBHI on health outcomes in Sub-Saharan Africa. We systematically assessed the evidence connected with CBHI membership. We searched and conducted a systematic search for relevant literature on online via Google search engine. These studies were published between 2004 and 2018. Both quantitative and mixed studies which adopted different study designs were included in the review. Inclusion criteria were met by 8 studies with 3 of the studies published in Ethiopia, 2 in Rwanda and one each in Burkina Faso, Nigeria and Senegal. Both quantitative and mixed studies show that CBHI enhances healthcare utilisation/accessibility and reduce out-of-pocket payment. Only two studies show that CBHI improves quality of life and healthcare quality. Despite this, 50% of the studies reported on various problems confronting the operations of CBHI schemes. Community-Based Health Insurance scheme has the potential of making healthcare accessible and affordable to the poor. However, there are loopholes that stakeholders need to address to make the scheme deliver effective healthcare service delivery.