BMJ  2007;334:1282-1283 (23 June), doi:10.1136/bmj.39240.632963.80

Editorials

Community based health insurance in developing countries

Removing financial barriers is only the first step towards better access to care for poor people

The first 150 words of the full text of this article appear below.

In this week's BMJ, a cluster randomised controlled trial by Ranson and colleagues describes a community based health insurance scheme run by the Self Employed Women's Association (SEWA) in Gujarat, India.¹ Community based health insurance is a valuable way to finance the delivery of health services in developing countries. By combining the risk of falling sick with resources, such insurance facilitates access to care and offers financial protection against the cost of illness. In doing so, community based health insurance aims to overcome inequities in access and socioeconomic status by reducing existing gaps between the poor and the less poor.

Research from Asia and sub-Saharan Africa shows that community based health insurance has been less effective in securing equity than expected. Poor people are less likely to enrol in such schemes,^{2 3 4} and limited evidence shows that once enrolled their use of the services is not great enough to compensate . . . [Full text of this article]

Department of Tropical Hygiene and Public Health, University of Heidelberg, 69120 Heidelberg, Germany

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Equitable utilisation of Indian community based health insurance scheme among its rural membership: cluster randomised controlled trial

M Kent Ranson, Tara Sinha, Mirai Chatterjee, Fenil Gandhi, Rupal Jayswal, Falguni Patel, Saul S Morris, and Anne J Mills
BMJ 2007 334: 1309. [Abstract] [Full Text] [PDF]