Community-Based Health Insurance, Healthcare Utilization, and Financial Protection in Burundi: The Effects of Co-payments and Household Ability to Pay on Progress Toward Universal Health Coverage
DOI:
https://doi.org/10.59413/ajocs/v7.i4.24Keywords:
Community-Based Health Insurance, Healthcare utilization, Financial protection, Universal Health Coverage, Health financingAbstract
Despite global efforts to achieve universal health coverage (UHC), financial barriers remain a major constraint to healthcare access in Burundi. Though Community-Based Health Insurance (CBHI) has been promoted as a mechanism to increase healthcare utilization and strengthen financial protection; longitudinal evidence on its performance in Burundi remains very limited. Our study analyzes trends in Community-Based Health Insurance coverage, healthcare utilization, and financial protection indicators in Burundi from 2019 to 2025 by using a time-series analytical approach. Drawing on empirical evidence from global health financing research, this study examines temporal changes in insurance participation, healthcare service use, and exposure to financial hardship associated with healthcare costs. Trend analysis and forecasting methods are applied to assess historical patterns and estimate future trajectories. This study provides evidence on the evolving role of CBHIs within Burundi’s health financing landscape and identifies factors influencing its effectiveness, sustainability, and equity. We hope the results of this research will contribute to inform policy strategies for strengthening insurance coverage, improving the Paquet Minimum d’Activités (PMA) utilization, and reducing financial vulnerability among underserved populations since patient co-payment is unilaterally fixed without taking into consideration the ability to pay CBHIs members. This research contributes to broader discussions on sustainable health financing and the pathways toward achieving equitable universal health coverage in resource-constrained areas.
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Copyright (c) 2026 Dr. Etienne Buregeya, Dr. Emmanuel Nizigiyimana, Prof. Jean de Dieu Ndikumana (Author)
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