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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