Impact of mutual health organizations: evidence from West Africa

TLDR

Mutual health organizations (MHOs) are voluntary membership organizations that provide health insurance services to their members. MHOs aim to increase access to health care by reducing out‑of‑pocket payments faced by households. We applied multivariate regression to household survey data from Ghana, Mali and Senegal to assess determinants of MHO enrolment and its effects on health service use and out‑of‑pocket expenditures. Households headed by women, with higher education, and from the richest quintile are more likely to enrol in MHOs, while no evidence shows that poorest households are excluded.

Abstract

Mutual health organizations (MHOs) are voluntary membership organizations providing health insurance services to their members. MHOs aim to increase access to health care by reducing out-of-pocket payments faced by households. We used multiple regression analysis of household survey data from Ghana, Mali and Senegal to investigate the determinants of enrolment in MHOs, and the impact of MHO membership on use of health care services and on out-of-pocket health care expenditures for outpatient care and hospitalization. We found strong evidence that households headed by women are more likely to enrol in MHOs than households headed by men. Education of the household head is positively associated with MHO enrolment. The evidence on the association between household economic status and MHO enrolment indicates that individuals from the richest quintiles are more likely to be enrolled than anyone else. We did not find evidence that individuals from the poorest quintiles tend to be excluded from MHOs.