Abstract

This paper analysed the impact of agricultural cooperatives (ACs) on health insurance participation among small-scale rice farmers in Rwanda. It seeks to fill the existing gap in understanding how ACs influence health insurance behaviours, utilising a structural analysis through the Theory of Planned Behaviour (TPB). This paper employed a cross-sectional research design, collecting data using a structured questionnaire. The sample comprised 273 members of KOAIRWA, a co-operative located in Huye District, selected via simple random sampling. Quantitative data were analysed using Partial Least Squares Structural Equation Modeling (PLS-SEM) to assess the reliability and validity of constructs and examine their interrelationships. The findings reveal that positive attitude towards health insurance (path coefficient = 0.565, p < 0.001), strong perceived behavioural control (path coefficient = 0.598, p < 0.000) and influential subjective norms (path coefficient = 0.727, p < 0.012) significantly drive health insurance participation. The results underscore the essential roles of attitudes, perceived behavioural control and social influences in promoting health insurance participation among small-scale rice farmers. Recommendations include leveraging co-operative structures to enhance health insurance education, streamlining enrolment processes and mobilising community leaders as advocates for the adoption of health insurance.

Keywords

Health insurance, agricultural cooperatives, small-scale farmers, Theory of Planned Behaviour, Rwanda, PLS-SEM.