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Table 1 Summary of key findings under individual level

From: Barriers and facilitators to implementation, uptake and sustainability of community-based health insurance schemes in low- and middle-income countries: a systematic review

Individual-level factors

Number and type of studies a

Reported as barrier

Reported as facilitator

Related to b

Implementation

Uptake

Sustainability

Consumer awareness and understanding of scheme

 Consumer awareness of scheme

N = 6

Cross-sectional (3); Mixed (3)

N = 2

[42, 44]

N = 4

[36, 41, 43, 45]

 

X

 

 Consumer understanding of concept of health insurance

N = 15

Qualitative (2); Cross-sectional (5); Mixed (5); Case studies (3)

N = 10

[31, 38, 46,47,48, 53,54,55,56,57]

N = 5

[41, 49,50,51,52]

 

X

X

Attitude factors

 Consumer trust in insurer

N = 12

Qualitative (1); Cross-sectional (6); Mixed (4); Case studies (1)

N = 6

[42, 46, 52, 53, 55, 58]

N = 6

[31, 33, 45, 58,59,60]

 

X

X

 Sense of ownership of scheme

N = 5

Cross-sectional (3); Mixed (2)

N = 1

[53]

N = 4

[33, 47, 58, 61]

 

X

X

 Perceived financial risk protection

N = 4

Qualitative (2); Mixed (2)

–

N = 4

[47, 56, 62, 63]

 

X

X

 Perceived quality of care

N = 10

Cross sectional (5); Case study (1); Mixed (4)

N = 6

[42,43,44, 53, 65, 73]

N = 4

[45, 52, 58, 64]

 

X

X

 Satisfaction with services

N = 5

Cross-sectional (5)

N = 3

[38, 52, 65]

N = 2

[36, 66]

  

X

Personal pre-disposition

 Previous experience with local groups

N = 5

Cross-sectional (2); Mixed (3)

N = 3

[33, 43, 47]

N = 2

[32, 67]

 

X

 

 Affordability of care

N = 4

Cross-sectional (2); Qualitative (1); Case study (1)

N = 2

[48, 54]

N = 2

[33, 52]

 

X

X

 Health status

N = 18

RCT (1); Cross-sectional (12); Mixed (5)

N = 4

[11, 38, 56, 65]

N = 15

[32, 34,35,36,37, 39, 40, 45, 56, 58, 66,67,68,69,70]

 

X

X

Socio-demographic factors

 Age (middle to old age)

N = 9

Cross-sectional (6); Mixed (3)

–

N = 9

[34, 35, 39, 40, 43, 58, 65, 67, 71]

 

X

 

 Gender (female)

N = 4

Cross-sectional (3); Mixed (1)

–

N = 4

[39, 40, 45, 71]

 

X

 

 Being married

N = 4

Cross-sectional (2); Mixed (2)

–

N = 4

[35, 39, 45, 68]

 

X

 

 Being employed

N = 4

Cross-sectional (3); Mixed (1)

–

N = 4

[35, 36, 45, 66]

 

X

 

 Ethnicity (minority)

N = 3

Cross-sectional (1); Mixed (1); Case study (1)

N = 3

[45, 49, 64]

–

 

X

 

 Migration status

N = 1

Cross-sectional (1)

N = 1

[39]

–

 

X

 

 Religious affiliation (Christian)

N = 4

Cross-sectional (2); Mixed (2)

N = 2

[68, 70]

N = 2

[32, 65]

 

X

 

 Occupational setting (rural)

N = 2

Cross-sectional (1); Mixed (1)

N = 1

[65]

N = 1

[43]

 

X

 

 Per capita expenditure (higher level)

N = 4

Cross-sectional (3); Mixed (1)

N = 1

[65]

N = 3

[58, 64, 67]

 

X

 

 Economic status (higher level)

N = 14

Cross-sectional (9); Mixed (5)

N = 2

[66, 68]

N = 12

[11, 32,33,34,35, 39, 45, 56, 58, 64, 67, 70]

 

X

 

 Education (higher level)

N = 10

Cross-sectional (7); Mixed (3)

N = 3

[35, 36, 66]

N = 7

[40, 43, 45, 64, 65, 67, 68]

 

X

 
  1. a Some of the studies included both barriers and facilitators
  2. b X symbol denotes whether the factor relates to implementation, uptake or sustainability