The inequitable impact of health shocks on the uninsured in Namibia
Open Access
- 28 July 2010
- journal article
- research article
- Published by Oxford University Press (OUP) in Health Policy and Planning
- Vol. 26 (2), 142-156
- https://doi.org/10.1093/heapol/czq029
Abstract
The AIDS pandemic in sub-Saharan Africa puts increasing pressure on the buffer capacity of low- and middle-income households without access to health insurance. This paper examines the relationship between health shocks, insurance status and health-seeking behaviour. It also investigates the possible mitigating effects of insurance on income loss and out-of-pocket health expenditure. The study uses a unique dataset based on a random sample of 1769 households and 7343 individuals living in the Greater Windhoek area in Namibia. The survey includes medical testing for HIV infection which allows for the explicit analysis of HIV-related health shocks. We find that the economic consequences of health shocks can be severe for uninsured households even in a country with a relatively well-developed public health care system such as Namibia. The uninsured resort to a variety of coping strategies to deal with the high medical expenses and reductions in income, such as selling assets, taking up credit or receiving financial support from relatives and friends. As HIV-infected individuals increasingly develop AIDS, this will put substantial pressure on the public health care system as well as social support networks. Evidence suggests that private insurance, currently unaffordable to the poor, protects households from the most severe consequences of health shocks.Keywords
This publication has 12 references indexed in Scilit:
- Health Insurance and Other Risk-Coping Strategies in Uganda: The Case of Microcare Insurance Ltd.World Development, 2010
- Innovation In Namibia: Preserving Private Health Insurance And HIV/AIDS TreatmentHealth Affairs, 2009
- Health insurance reform in Vietnam: a review of recent developments and future challengesHealth Policy and Planning, 2008
- Adult Mortality and Consumption Growth in the Age of HIV/AIDSEconomic Development and Cultural Change, 2008
- Orphanhood and the Long‐Run Impact on ChildrenAmerican Journal of Agricultural Economics, 2006
- The Impact of Adult Mortality and Parental Deaths on Primary Schooling in North-Western TanzaniaThe Journal of Development Studies, 2005
- Community-based health insurance in low-income countries: a systematic review of the evidenceHealth Policy and Planning, 2004
- The impact of HIV/AIDS on labour productivity in KenyaTropical Medicine & International Health, 2004
- Income Risk, Coping Strategies, and Safety NetsThe World Bank Research Observer, 2002
- Income Smoothing and Consumption SmoothingJournal of Economic Perspectives, 1995