Factors determining voluntary health insurance ownership in Zambia.
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Date
2019
Authors
Kaunda, Bevan
Journal Title
Journal ISSN
Volume Title
Publisher
The University of Zambia
Abstract
In Zambia, the majority of people seek health care from public health facilities but evidence suggests that the poor still incur high out-of-pocket payments for health. Despite the government's efforts to provide free primary health care, health spending for secondary health care is still high, and this disproportionately affects the poor. In order to protect households from catastrophic health payments at the point of seeking care and to increase access to health services, the government intends to introduce the National Health Insurance to complement the existing voluntary health insurance. Currently, only 3.9 per cent of households have some form of health insurance in Zambia, and this is done on voluntary basis. Although several studies have been conducted in both developing and developed countries, there is limited evidence in the Zambian context on what determines health insurance ownership. This paper examines the factors that determine voluntary health insurance ownership in Zambia. Specifically, the paper establishes the socio-economic factors, demographic factors, and health status that are associated with ownership of health insurance. The study uses data from the 2014 Zambia Household Health Expenditure and Utilization Survey, which is nationally representative. We estimate a probit regression model to identify the factors associated with health insurance ownership. The results show that the level of education, employment status, region of residence, marital status, household size, and household expenditure are significantly associated with health insurance ownership in Zambia. Education, marital status and employment status were found to significantly increase the probability of owning health insurance. Moreover, study findings revealed that households that spend relatively more on goods and services were more likely to own health insurance. However, those households with relatively bigger family size and those residing in rural areas were less likely to own health insurance. The study further established that gender, age, and health status did not significantly determine health insurance ownership in Zambia. As the Zambian government introduces the national health insurance, policies that improve educational attainment and employment creation are likely to have an influence on the health insurance coverage, particularly in the context of a large informal sector.
Description
Thesis of Master of Arts in Economics.