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Health shocks and foregone care in rural Kenya . Igna Bonfrer 1 and Emily Gustafsson – Wright 2,3. 1 Institute of Health Policy & Management, Erasmus University Rotterdam 2 Brookings Institution Washington 3 Amsterdam Institute for International Development. Outline.
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Health shocks andforegone care in rural Kenya Igna Bonfrer1 and Emily Gustafsson – Wright2,3 1Institute of Health Policy & Management, Erasmus University Rotterdam 2 Brookings Institution Washington 3Amsterdam Institute for International Development
Outline • Research problem and associated research topics • Data and context • Results • Implications for policy and practice • Discussion points and further research
Research problem and topics • Research problem: Ruralhouseholds face a range of shocks whichcan have large financial impact, especiallywhenrelatedto health. • Research topics: • The importance of health shocks compared to other shocks • Composition of costs related to health shocks • Coping strategies • The extent of foregone care
Data • Baseline survey among 1226 randomly selected households, 7597 individuals (across two sites) • Great detail on health status (objective and subjective), health care expenditure and coping mechanisms • Module on household shocks • Limited information on foregone care but useful proxy variables
Locationand details case study • Project with Health Insurance Fund and PharmAccess • Two sites: seperate dairy farmer cooperatives • 75% of population in dairy farming
Results (4a) Foregone care • Self-reportedforegone care in het last year: 21% • Self-reported versus objectivehypertension in adults
Implications for policy and practice • Illness and injury among most important threats • Some form of protection to • i) prevent coping strategies with long term financial implications (selling livestocketc.) and • ii) limit foregone care There is considerable scope for health insurance to protect households financially and increase access. • Attractive borrowing options (banks) • Chronic burden (drugs) versus “shocks”
Discussion points and further research • Which perspective to use? - Foregone earnings due to illness or injury • Which funds are used for “dissaving”? • Prior to the introduction of health insurance: understanding the full chain of household decisions made when facing a shock