Background Community-based health insurance systems are usually voluntary and characterized by community members pooling funds and protecting themselves against the high costs of seeking medical care and treatment for illness. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected. This study aimed to determine client satisfaction with the community-based health insurance scheme and associated factors. Methods An institutional-based cross-sectional study design was applied from February 22–March 11 /2019. A total of 420 study participants were included in the study using a systematic random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire with a patient exit interview. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Community-based Health Insurance of client satisfaction. Statistical significance was decided at a p-value less than 0.05. Result A total of 420 community-based health insurance clients of health service users participated in the study with a 100% response rate. The overall client satisfaction was 80% at 95% Cl (76.1, 83.9), respondents who have perceived that partially or none availability of prescribing drugs were 0.09 times less likely satisfied as compared to full availability of prescribing drugs (AOR =0.09; 95% Cl: (0.04, 0.19)). Besides, study participants waiting time to consult service providers within 30 min were more satisfied than those who were delayed 60 min and above (AOR =3.16; 95% Cl: (1.19, 8.41)). Conclusion Community-based health insurance client satisfaction provided in the present study was 80% indicating low proportion. Full availability of prescribing drugs, clients renewed their community-based health insurance membership, and preference of clients to use the hospital for future health care need were positively associated with client satisfaction while the perception of waiting time before physician consultation negatively affected client’s satisfaction. Therefore, the hospital management members and service providers need to give attention to reduce waiting time preceding consultation, improve drug availability, and sustain the hospital preference by the client.

Background In-service training programs should be evaluated and modified regularly to provide quality health services. However, in Ethiopia, there is no published evidence about its effectiveness. Therefore, we evaluated the effectiveness of in-service training program of Amhara Public Health Institute Dessie Branch (APHI) using the Kirkpatrick model. Methods In October 2019, a concurrent nested mixed quantitative/qualitative, facility-based cross-sectional study was conducted among 107 stakeholders from 22 randomly selected east Amhara government health facilities. The qualitative part also involved all this key stakeholder interviews. Data was collected using a semi-structured questionnaire through face to face interview. Epi data manager and Microsoft Excel 2016 software’s were used for data entry and analysis respectively. The major qualitative findings were narrated and summarized based on thematic areas to supplement the quantitative findings. Results A total of 107 laboratory professionals working in 22 health facilities were interviewed with a response rate of 97.3%. At reaction level, 82.1% of participants strongly agreed/agreed with the course structure, training contents and learning tools. Likewise, 85.4% of them strongly agreed/agreed on trainer's knowledge and their communication skills. Besides, 93.1% of them stated an improvement in knowledge and skills after attending training. Yet, only 65.6% of participants transferred their knowledge and skills in to practice. Regarding the training set ups and environment, 45.1% of the respondents strongly disagreed/disagreed with the training hall, toilet, café, financial process, accommodation perdiem and, tea & snacks. Conclusion and recommendations: Generally speaking, the laboratory in-service training program of APHI was more or less effective. Our finding suggests regular monitoring and evaluation of training events based on a standard set of performance indicators. Furthermore, the institute is mandated to create a conducive learning environment and well established training set ups for trainees.