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Emily Gustafsson-Wright, PhD – Research Fellow Amsterdam Institute for International Development and Guest Scholar Brookings Institution
Jacques van der Gaag, PhD – Cofounder Amsterdam Institute for International Development and Senior Fellow Brookings Institution
This lecture presents preliminary findings of an impact evaluation of the health programs funded by the Health Insurance Fund (HIF) and implemented by the PharmAccess Foundation (PharmAccess) in Africa. This research is part of a multi-year operational research program on subsidized low-cost private health insurance and clinic-upgrades in several countries led by the Amsterdam Institute for International Development (AIID) and Amsterdam Institute for Global Health and Development (AIGHD). The study evaluates the basic short-term impact of the Hygeia Community Health Care (HCHC) program in Central Kwara State, Nigeria, based on two (of three) population-based household surveys in Kwara Central: a baseline survey in 2009 and a follow-up survey in 2011. The baseline and follow-up surveys are utilized to examine some of the initial impact of HCHC related to health. The focus is on the three main outcomes from health insurance interventions seen in the literature: (1) access and utilization of health care, (2) financial protection, and (3) health status. The evidence points to HCHC not only increasing utilization of health care among the insured (as well as in the treatment community overall), but also to the program increasing utilization of quality health care. In addition, the findings show that HCHC enhances financial protection by reducing out-of-pocket health expenditures. The findings on health status demonstrate a decline in self-reported health which may be indication of an increase in knowledge about health status with increased access to care. On the other hand, objective health measures demonstrate improvements in health as measured by a decline in hypertension among the insured.