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Does Community-Based Health Insurance Protect Household Assets? Evidence from Rural Africa

Keywords: Health insurance; Burkina Faso; instrumental variable; fixed effects;assets.

Objective: To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa.

Data Sources: Data were used from a household panel survey that collected primary data from randomly selected households, covering 41 villages and one town, during 2004–2007(n = 890).

Study Design: The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004–2006. We applied different strategies to control for selection bias—ordinary least squares with covariates, two-stage least squares with instrumental variable, and fixed-effects models.

Data Collection: Household members were interviewed in their local language every year, and information was collected on demographic and socio-economic indicators including ownership of assets, and on self-reported morbidity.

Principal Findings: Fixed-effects and ordinary least squares models showed that CBHI protected household assets during 2004–2007. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004–2005.

Conclusions: In this study, we found that CBHI has the potential to not only protect household assets but also increase household assets. However, similar studies from developing countries that evaluate the impact of health insurance on household economic indicators are needed to benchmark these results with other settings.

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