Achieving equity in health through community based health insurance: India's experience with a large CBHI programme

This paper analyses equity in one of the largest community based health insurance programme in India: Yeshasvini, run by the Department of Cooperation in Karnataka, a state in India. The analysis is based on a primary survey of 4109 households in rural Karnataka. The study covers various dimensions of vulnerability and assesses their relationship with enrolment, renewal of enrolment, and utilisation of health care services using logistic regression techniques. The results demonstrate that inequities do exist. However, they are less pronounced in the distribution of benefits than in enrolment and renewals. The study argues that while CBHI may be used as a mechanism to reach the most disadvantaged population groups, they can not be considered as substitute for government created health infrastructure.