Acceptability and effectiveness of two community based Health Insurance Schemes in Karnataka

Abstract

Background: Community based health insurance has been one of the options of health financing in India for a large number of population from the informal sector constituting about 90% of the total population. There are about 40 odd CBHI schemes in India as per crude estimates The functioning of each of these schemes differ from one another, but broadly categorized into three types. There has been studies on few of these schemes in terms of its functioning and coverage areas, a few studies dwelt into the impact of these schemes in the target population and also utilization of the schemes by those enrolled. But there has been gaps in this area in terms of empirical evidence on factors influencing take up of these schemes. This objectives of this study were to find out what are the determinants which has influenced the beneficiaries of the CBHI schemes to enroll, by comparing them to a non-insured group and to find out the performance of the schemes the technical and organizational characteristics. The bases for the insured group were beneficiaries of two prominent CBHI schemes the Manipal Arogya Suraksha and the Sampoorna Suraksha operating in the study area. Methods: A combination of both qualitative and quantitative method was used to carry out the study .A cross sectional household survey, focus group discussions and indepth interviews were carried out. Surveys on 1638 households were carried out, which had 1108 insured household to 530 non-insured which was a 2:1 ratio. This was done using a two stage sampling method. Data was analyzed using the SPSS 20 where descriptive, univariate and multivariate analysis was carried out. Results: The multivariate analysis revealed that, household variables such as gender of household head, religion, family size, were determinants along with variables like literacy, occupation and marital status of the individuals.