"To enrol or not to enrol?": A qualitative investigation of demand for health insurance in rural West Africa
"To enrol or not to enrol?": A qualitative investigation of demand for health insurance in rural West Africa
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DOI：
10.1016/j.socscimed.2005.07.036
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发表时间：
2006-03-01
影响因子：
5.4
通讯作者：
Sauerborn, R
中科院分区：
文献类型：
--
作者：
De Allegri, M;Sanon, M;Sauerborn, R
尽管低水平的参与长期以来一直被认为是在低收入国家长期成功实施社区健康保险的主要制约因素，但仍然缺乏关于社区健康保险入学决定因素的证据。计量经济学模型的应用为这个问题提供了部分答案，但事实证明，它本身不足以指导政策制定。本文旨在用定性研究方法填补这一知识空白。在西非布基纳法索努纳卫生区对32名户主进行了深入访谈，以评估新设立的社区倡议计划的入学决定因素。研究结果强调，以前在文献中被忽视的因素，如制度僵化和社会文化习俗，在塑造入学的决定中发挥了重要作用。对调查结果的讨论侧重于政策影响，为布基纳法索内外最大限度地提高入学率提出了具体建议。(c)2005爱思唯尔有限公司保留所有权利。
In spite of the fact that feeble levels of participation have long been identified as a major constraint to the successful long-term implementation of community-based health insurance (CBI) in low-income countries, evidence on determinants of enrolment in CBI is still lacking. The application of econometric modelling has provided a partial answer to the question, but on its own it has proved to be insufficient to guide policy making. This paper aims to fill this gap in knowledge using qualitative research methods. In-depth interviews with 32 household heads were conducted in the Nouna Health District, Burkina Faso, West Africa to assess determinants of enrolment in a newly established CBI scheme. The findings highlight that factors previously neglected in the literature, such as institutional rigidities and socio-cultural practices, play an important role in shaping the decision to enrol. The discussion of the findings focuses on the policy implications, offering concrete recommendations to maximise enrolment, within and beyond Burkina Faso. (c) 2005 Elsevier Ltd. All rights reserved.