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Health shocks and foregone care in rural Kenya

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 and foregone care in rural Kenya

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  1. 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

  2. Outline • Research problem and associated research topics • Data and context • Results • Implications for policy and practice • Discussion points and further research

  3. 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

  4. 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

  5. Locationand details case study • Project with Health Insurance Fund and PharmAccess • Two sites: seperate dairy farmer cooperatives • 75% of population in dairy farming

  6. Results (1a) Relativeimportance of shocks

  7. Results (1b) Relativeimportance of shocks

  8. Results (2) Health care expenditure

  9. Results (3) Dominant financial coping strategies

  10. Results (4a) Foregone care • Self-reportedforegone care in het last year: 21% • Self-reported versus objectivehypertension in adults

  11. 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”

  12. 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

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