Informing the design of policies aimed at increasing health financial protection to accelerate universal health coverage in West Africa

2024 Fiscal Year Research-status Report

• Project/Area Number: 23K24567
• Allocation Type: Multi-year Fund
• Research Institution: Hitotsubashi University
• Principal Investigator: Rouyard Thomas 一橋大学, 社会科学高等研究院, HIAS客員研究員 (40859542)
• Co-Investigator(Kenkyū-buntansha): 中村 良太 一橋大学, 社会科学高等研究院, HIAS客員研究員 (00717209)
• Project Period (FY): 2024-04-01 – 2026-03-31
• Keywords: UHC / Access to care / LMIC / West Africa

Outline of Annual Research Achievements

Since the start of the second phase of the project, we have continued preparations for the simulation analysis that aims to project changes in the proportion of households facing catastrophic health expenditures (CHE) and impoverishing health expenditures (IHE) under different insurance coverage scenarios across WAEMU（West African Economic and Monetary Union）countries. We have developed the methodological framework for these simulations, including defining the key scenarios to be analyzed and specifying additional parameters such as insurance premium fees and health benefits packages. These preparations lay the groundwork for conducting robust policy simulations once the panel dataset is fully ready.

Current Status of Research Progress

3: Progress in research has been slightly delayed.

Reason

Progress on the projection analysis has been delayed due to technical issues identified during dataset preparation. Specifically, coding errors and inconsistencies in household matching between the first and second waves of the WAEMU household survey compromised the panel structure required for this phase of the project. These matching problems prevented us from proceeding with the simulation work as originally planned. Over the past months, we have worked closely with our collaborators at WAEMU, including the country teams responsible for data collection, to systematically address these issues. As of April 2025, the matching problems are nearly resolved, which will enable us to move forward once the first manuscript -focused on the determinants and persistence of IHE - is completed.

Strategy for Future Research Activity

Following the completion of the first manuscript, we will proceed with the projection analysis outlined for the second phase. Using the finalized panel dataset, we will simulate changes in CHE and IHE rates under various insurance coverage scenarios for each country and for the WAEMU region as a whole. Assuming the remaining technical work proceeds smoothly, we expect to complete this second phase of analysis during FY2025 and submit a second manuscript for publication. This second output will provide critical evidence to guide the design and expansion of health insurance mechanisms to improve financial protection in WAEMU countries.

Causes of Carryover

We plan to use these funds to cover open access fees for disseminating the findings.