Abstract #112242

Marty Makinen, PhD, PHRplus Project, Abt Associates Inc., 4800 Montgomery Lane, Bethesda, MD 20814, 301-913-0689, marty_makinen@abtassoc.com

This paper examines the effect of community-based health insurance schemes on the use of child health services in Mali. The study focuses on two districts where schemes have been offered to part of the population over the last two years (urban Sikasso and rural Bla). Other parts of each district's population have not been offered scheme membership to maintain them as controls.

The voluntary schemes collect premiums that are pooled to pay providers for services used by members. The aim is to reduce the barrier to use of care represented by user fees. It also is expected that scheme membership makes more likely the use of preventive services.

In late 2004, surveys of approximately 2,500 households (covering about 14,000 individuals, of which about 2,800 are children under five) were conducted in the two districts covering populations offered and not offered scheme membership. The questionnaires covered household demographics, socio-economic status, and use of and payment for health services. The 2004 survey follows on a similar survey implemented in 1999. Specifically, the survey results address the following questions:

1. What are the socio-economic status factors that influence families with children under five to join schemes? 2. How does scheme membership affect the use of key preventive child health services, specifically: immunizations, vitamin A supplementation, and sleeping under insecticide treated nets? 3. How does scheme membership affect the use of important curative child health services, specifically: fevers presumed to be malaria and treatment of diarrhea?

Learning Objectives:

• How community-based health insurance schemes work in Mali
• What socio-economic factors contribute to joining voluntary schemes
• What impact scheme membership has on the use of child health services, both preventive and curative

Keywords: Child Health, Insurance

Related Web page: www.phrplus.org

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.