An appraisal of the effectiveness of community-based health insurance in reducing out-of-pocket healthcare expenses in Ilesa West Local Government Area, Osun State
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- NGN 5000
Background of the Study
Community-based health insurance (CBHI) schemes have emerged as a pivotal strategy for mitigating financial barriers to healthcare, particularly in low-resource settings such as Ilesa West Local Government Area, Osun State (Ade, 2023). These schemes pool resources among community members, thereby reducing direct out-of-pocket expenditures that often prevent individuals from seeking necessary medical care. Over recent years, CBHI has gained prominence as an innovative approach to achieve equitable healthcare financing; however, challenges such as low enrollment rates, limited benefit packages, and operational inefficiencies remain (Chin, 2024). This study critically examines the effectiveness of CBHI in lowering healthcare expenses, considering factors such as scheme coverage, service quality, and economic impact. It further explores the relationship between community trust and scheme performance, aiming to provide an evidence-based assessment of its role in financial risk protection (Akinola, 2025).
Statement of the Problem
Despite the implementation of CBHI schemes in Ilesa West, many residents continue to face significant out-of-pocket healthcare expenses (Balogun, 2023). Low enrollment rates, limited benefit packages, and operational challenges undermine the potential of these schemes to provide effective financial protection. Consequently, households remain vulnerable to catastrophic health expenditures. This study seeks to identify the specific factors limiting the success of CBHI programs and evaluate their overall impact on reducing healthcare costs, providing data to inform improvements in financial risk protection (Ibrahim, 2024).
Objectives of the Study:
To evaluate the impact of CBHI on out-of-pocket healthcare expenses.
To assess enrollment rates and benefit adequacy of the CBHI scheme.
To propose recommendations for improving the effectiveness of CBHI programs.
Research Questions:
How effective is the CBHI scheme in reducing out-of-pocket expenses?
What factors influence enrollment and benefit adequacy in the CBHI scheme?
What strategies can enhance the financial protection offered by CBHI?
Research Hypotheses:
CBHI enrollment is inversely related to out-of-pocket healthcare expenditures.
Inadequate benefit packages diminish the financial effectiveness of CBHI.
Strengthening community trust will improve CBHI performance and enrollment rates.
Significance of the Study
This study is significant as it provides insights into the effectiveness of community-based health insurance in reducing financial burdens on households. The findings will inform policymakers and stakeholders on improving CBHI schemes to achieve better healthcare financing outcomes, contributing to sustainable health financing reforms in low-resource settings (Ogunleye, 2025).
Scope and Limitations of the Study:
Limited to the topic only.
Definitions of Terms:
Community-based health insurance: A system where community members pool funds to cover healthcare costs.
Out-of-pocket expenses: Direct payments made by individuals for healthcare services.
Financial risk protection: Measures that safeguard households from catastrophic health expenditures.
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