Complementarities between social protection and health care policies: Evidence from the Productive Safety Net Program in Ethiopia

A presentation on  "Complementarities between social protection and health care policies: Evidence from the Productive Safety Net Program in Ethiopia" was given by Kalle Hirvonen of IFPRI-ESSP (co-authored by Anne Bossuyt and Remy Pigois of UNICEF Ethiopia) at the Ethiopian Development Research Institute (EDRI) on October 6, 2017. The study explores complementarities between three major national social protection programs in Ethiopia: the Productive Safety Net Programme (PSNP), the Health Fee Waiver (HFW) system and the Community Based Health Insurance (CBHI) in the Ethiopian highlands (Amhara, Oromia, SNNP and Tigray regions).

Using PSNP-4 baseline data collected by the Central Statistical Agency (CSA) of Ethiopia in 2016, the research unfolded that, in woredas where CBHI does not operate, only 3.5 percent of PSNP households report having benefited from the HFW. The CBHI operates in about one third of the PSNP woredas in the Ethiopian highlands. In these woredas, nearly 22 percent of all PSNP beneficiary households are enrolled into CBHI. No evidence was found to indicate that PSNP households are more (or less) likely to enroll into CBHI than other poor households. For only 10 percent of all PSNP beneficiary households the insurance premium was waived. Considering that PSNP consists of the poorest and most food insecure households who would potentially greatly benefit from health insurance, this relatively low proportion is of concern. In addition, 10 percent of PSNP households have experienced a serious income shock because of an illness, resulting in loss of consumption or loss of assets. Finally, many households, even those enrolled in CBHI or benefitting from HFW, incur out-of-pocket health expenditures. This to suggest that CBHI and HFW do not fully cover all health care costs relevant to households. Overall, these findings suggest that more work remains to be done to better link these three major social protection programs in Ethiopia in order to protect the poorest and most vulnerable households. Full details of this presentation can be found here.

This presentation was organized by ESSP and EDRI. ESSP is a collaborative program undertaken by IFPRI and EDRI, whose objective is to help improve the policy-making decision process in Ethiopia.

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