Abstract:In low income countries households are the principal health financing agents. Their expense goes not without shrinking the basic consumptions of the household. This cost is not even enough to avert the consequences either. As a consequence it perpetuates the vicious cycle between sickness and poverty. Control of diseases or their outcome will depend on socioeconomic determinants. Understanding what affects willingness-to-pay (WTP) for medical care is very important to design choices about the allocation of scarce resources. The objective of this study was to assess the association between socioeconomic status and WTP for medical care among government school teachers in Addis Ababa. A cross sectional survey methodology was employed and a structured questionnaire was administered to 847 government school teachers between January to March 2011. The sample was generated by a two-stage probability proportional to size sampling (PPS) method. A dichotomous choice contingent valuation method (CVM) in the single bound formulation was used to elicit a "yes" or "no" answer by respondents when asked if they are WTP a given bid for medical care. Three hypothetical case scenarios: common cold (CC), glaucoma (BD) and heart attack (HAT) were designated. Both descriptive and analytic statistics were used to analyze the data. The degree and strength of association between the explanatory variables and willingness to pay were evaluated by logistic regression. Generally more respondents were WTP for CC, BD and HAT in government than private facilities. In government facilities WTP for CC and BD did not vary with socioeconomic status. However WTP for HAT was lower in the low income group and educational status. In private facilities WTP for CC varied with land ownership only.WTP for both BD and HAT was higher in those with better income and who own land. Educational level, proxy indicators of wealth, income level, lower medical care costs and seriousness of illness were found to positively influence the WTP for medical care. Improving employment benefits and establishing a mechanism to help raise the ability to pay are commendable policy measures.

Abstract:Background: Institutional structure, also called institutional formation is defined as the components and resources that an institution has to deliver its services and generate external support. Until recently, human resources have been overlooked during the course of health sector reforms. The perception of health worker towards institutional structure and leadership have an enormous impact for the successful implementation of health sector reform thus identifying factors that affect their perception have a significant importance for amending some of the organizational structure and advancing strategies to achieve organizational goals. And identifying factors that affect perception of health workers have eminent roles for mangers in order to improve and create a motivated health care provider. Objective: The objective of this study was to assess and determine factors that affect the perception of healthcare Workers towards the institutional structure and Leadership. Methods: A cross sectional quantitative survey was undertaken on 204 health workers from April 15 -30, 2012. Self administered structured questionnaires were used to collect data. Data were entered and analyzed using SPSS Version 16. Multiple linear regressions were applied once after the assumptions checked. Result: This study showed that the overall perception of institutional structure and leadership is 37.2% and 31.6% respectively. About 59.3% of the respondents perceived that their Hospital did not give enough emphasis on the quality of service it provides and 69.6% of the health workers perceived that there were inadequate facilities. Educational status and place of work have shown association for the perception of health workers towards institutional structure while position was the only predictor for perception of health workers towards institutional leadership. Conclusion and Recommendation: Seeing the overall perception of health workers towards institutional structure and leadership was very low, promoting health workers based on their performance and strengthening Facilities infrastructure is decisive.