Achieving universal health coverage through voluntary insurance: what can we learn from the experience of Lao PDR?

BMC Health Services Research
Sarah AlkenbrackMagnus Lindelow

Abstract

The Government of Lao Peoples' Democratic Republic (Lao PDR) has embarked on a path to achieve universal health coverage (UHC) through implementation of four risk-protection schemes. One of these schemes is community-based health insurance (CBHI) - a voluntary scheme that targets roughly half the population. However, after 12 years of implementation, coverage through CBHI remains very low. Increasing coverage of the scheme would require expansion to households in both villages where CBHI is currently operating, and new geographic areas. In this study we explore the prospects of both types of expansion by examining household and district level data. Using a household survey based on a case-comparison design of 3000 households, we examine the determinants of enrolment at the household level in areas where the scheme is currently operating. We model the determinants of enrolment using a probit model and predicted probabilities. Findings from focus group discussions are used to explain the quantitative findings. To examine the prospects for geographic scale-up, we use secondary data to compare characteristics of districts with and without insurance, using a combination of univariate and multivariate analyses. The multivariate analy...Continue Reading

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Citations

Apr 18, 2014·Health Policy and Planning·Kristina JönssonGöran Tomson
Nov 21, 2014·BMC Health Services Research·Jane MachaJosephine Borghi
Oct 21, 2015·BMC Health Services Research·Sarah AlkenbrackMagnus Lindelow
May 22, 2018·The International Journal of Health Planning and Management·Asmamaw Atafu, Soonman Kwon
Jul 28, 2018·Asia-Pacific Journal of Public Health·Sungkyoung ChoiSo Yoon Kim
Aug 4, 2018·International Journal of Environmental Research and Public Health·Abdur Razzaque SarkerJahangir A M Khan
Nov 30, 2019·International Journal of Health Policy and Management·Prabesh GhimireAmod Kumar Poudyal
Sep 15, 2020·ClinicoEconomics and Outcomes Research : CEOR·Naser DerakhshaniVladimir Sergeevich Gordeev

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