Does community-based health insurance protect household assets?: evidence from rural Africa

Objective: To evaluate whether community-based health insurance (CBHI) protects household assets in rural Burkina Faso, Africa Data sources: Data was used from a household survey that collected primary data from randomly selected households, covering 42 villages and 1 town, during 2004-07(n=890). Study design: The study area was divided into 33 clusters and CBHI was randomly offered to these clusters during 2004-06. 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 socioeconomic 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 2004-07. The two-stage least squares with instrumental variable model showed that CBHI increased household assets during 2004-05. Conclusions: CBHI protects household assets. For a subsidized scheme, CBHI also has the potential to increase household assets. 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