The Burden of Chronic Disease on Households in Tanzania and Kenya: Evidence from the Health Insurance Fund Operational Research
A Study for USAID
While infectious diseases continue to plague much of sub-Saharan Africa, the increase in prevalence of chronic disease is compounding an already desperate situation. By 2030, in fact, chronic disease mortalities are expected to overtake those of infectious diseases in sub-Saharan Africa. If not addressed effectively, over the next decade, chronic disease is expected to increase by nearly one-third in Africa and will account for 75% of deaths globally.2 This rise in chronic conditions places new long-term demands on health care systems because these conditions require ongoing management over many years. From both an economic and a health perspective, this poses a particular threat to those countries whose systems are the least equipped to manage. Furthermore, the poorest individuals in those countries have the highest risk of developing chronic disease and are the least able to cope with them.
The Health Insurance Fund (HIF) and its implementing partner the PharmAccess Foundation (PAF) provide an innovative model whereby they work for the benefit of doctors and patients through insurance for low and middle income people, loans to doctors, clinical standards and quality improvements, private investments (Investment Fund for Health in Africa) and operational research (Amsterdam Institute for Global Health and Development).
Together, this group of organizations aims to improve access to affordable quality basic health care by building sustainable, integrated health systems through public-private partnerships in Africa. This is achieved by stimulating both the demand and supply side, measuring and improving (medical) quality, stimulating investments in healthcare and increasing the amount of money in the system, leveraged by donor contributions.
These programs aim to ensure affordable health care access including the prevention and treatment of chronic illnesses in several African countries including Tanzania and Kenya –the most recent of the HIF program countries. This study draws on two rich datasets from these two countries gathered as part of a multi-year operational research program on the HIF programs led by the Amsterdam Institute for International Development (AIID) and the Amsterdam Institute for Global Health and Development (AIGHD).
The central objective of this study for USAID is to provide valuable knowledge relating to chronic disease; a key component of the Health Insurance Fund insurance programs. This study informs the design of the HIF insurance packages and/or other potential interventions as well as the potential coverage gap. The study provides not only a better understanding of the potential benefits of health insurance, but also information about how much individuals might be willing to pay for health insurance based on what they are already paying out-of-pocket on health.
Click here to read the full article.