Ethiopia Community-Based Health Insurance Scheme

Ethiopia introduced its Community-Based Health Insurance scheme in June 2011 as a pilot initiative under the government's revised healthcare financing strategy, aimed at increasing demand for health care, enhancing financial protection and mobilizing domestic revenue for the health sector. The pilot launched in 13 districts across the Tigray, Amhara, Oromia and Southern Nations, Nationalities and Peoples regions, enrolling roughly 301,000 households on a voluntary basis, with annual premiums of 126 to 180 Ethiopian birr per household, representing 0.5 to 1 percent of household monthly income. District-level, or woreda, schemes identify and contract health facilities, reimburse providers for beneficiary services, manage member finances and maintain membership records, and enrolled members face no co-payments at contracted public facilities. The scheme scaled up nationally in rural areas from 2013, reaching pastoralist regions including Somali only from 2020, and national enrolment coverage reached 50 percent by 2020 against an original target of 80 percent.