Community-based health insurance and healthcare service utilisation, North-West, Ethiopia: a comparative, cross-sectional study

Atnafu, Desta Debalkie; Tilahun, Hiwot; Alemu, Yihun Mulugeta

doi:10.1136/bmjopen-2017-019613

Cited by 60 publications

(81 citation statements)

References 21 publications

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“…Marriage was also well articulated as a determinant for CBHI utilization. Being married was a positive factor to the WTJ to CBHI [23,37] and enrolment in the scheme [20,43,47,62]. According to family/household size, in most studies, it was a positive predictor for CBHI utilization [1, 18, 20, 22, 23, 37-39, 41, 42, 44-51, 62].…”

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

“…It was also negatively related with satisfaction of CBHI utilization [40,57]. Family size was positively associated with the WTJ in [1,23,37], WTP for [1,38,39,41,42], participation in [18,22], enrolment to [20,44,47,48,50,51,62], uptake of [45,46] and attitude of CBHI [49]; but negatively linked with [40,57] the scheme. Pointing to educational status of the household, twenty one studies reported that education was a positive determinant to CBHI utilization [1, 15, 18, 21, 23, 36, 38-44, 46-49, 57, 60-63] while two studies reported it as a negative predictor to scheme uptake [37,64].…”

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

“…Quality, availability, accessibility, coverage, adequacy of health service and capacity and readiness of health facility were positively related with scheme uptake [12, 36, 38, 40, 42, 44, 46-48, 50, 51, 53, 54, 61, 62, 64]. Service adequacy was positively related with the interest to [12], WTP for [38,40,42], WTJ [36], enrolment to [44,47,48,50,51,62,64], the knowledge, attitude and practice to be a member in [61] to satisfy with [53,54] and utilization of [46] CBHI. Insufficiency of health service both in equipment and human power was a negative predictor to the scheme's utilization [12].…”

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

“…Health sector distance was negatively related with the participation in [18], enrolment to and WTJ [37] CBHI. Travel time was negatively associated with the enrolment to the scheme [59,62]. Waiting time was also negatively related with the WTP for [40] and utilization of [46] CBHI.…”

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

“…On the other side, if most of the family members became younger, the WTU the scheme was found to be increased; i.e., since the scheme covers family members up to 18 years of age, families with greater younger members were more willing to utilize the scheme than those families with older members [17,20,37,40,61]. With respect to marriage, the WTU the scheme was found to be more among those who were married than those who were not which entails us that social work is mandatory to keep intact family; minimizing/avoiding divorce to protect the family is important to increase CBHI utilization [20,23,37,43,47,62]. Regarding to family size, as it increased; the WTU the scheme did so.…”

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

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Factors affecting community based health insurance utilization in Ethiopia: A systematic review

Bayked¹,

Kahissay²,

Workneh³

2019

Preprint

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Background: The goal of health care financing in Ethiopia has been to achieve universal health care coverage by minimizing the catastrophic out of pocket health service expenditure. Even though the performance was not as planned, the promising strategy to achieve universal health care coverage in the informal sector was community based health insurance which was expected to cover more than 83 % of the population. So, we systematically reviewed determinants of community based health insurance utilization in Ethiopia. Methods: We searched DOAJ, EconBiz, ERIC, Google Scholar, Oxford Journals, PubMed, SpringerLink, Europe PMC, Microsoft Academic Search, OAIster and AJ including various relevant websites by March 9 to 10, 2019. We included articles regardless of their publication status with both quantitative and qualitative approaches. Results: The factors determining community based health insurance utilization in Ethiopia were found to be associated with supply side, health facility, demographic and socioeconomic predictors. Among demographic and socio-economic factors, the report of the studies regarding to gender and age was not consistent. However income, education, community participation, marriage, occupation and family size were found to be significant predictors and were positively related with the scheme’s utilization. With respect to health status and health service related factors; illness experience, benefit package, awareness level, previous out of pocket expenditure for health care service and health service status (quality, adequacy, efficiency and coverage) were significantly and positively related but premium amount, self-rated health status and bureaucratic complexity were found to be negative predictors. Conclusion: To achieve universal health care coverage through community based health insurance, it is advisable that special attention should be given to income level, education, community participation, marriage, family size, benefit package, awareness level and health service quality, premium amount and bureaucratic or governance issue.

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Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

Section: Demographic and Socio-economic Factorsmentioning

confidence: 99%

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Factors affecting community based health insurance utilization in Ethiopia: A systematic review

Bayked¹,

Kahissay²,

Workneh³

2019

Preprint

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Health care utilization and its association with sociodemographic factors among slum‐dwellers with type 2 diabetes in Tabriz, Iran: A cross‐sectional study

Ghammari

Jalilian

Khodayari‐Zarnaq

et al. 2023

Health Science Reports

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Background and Aims Slums are known as growing underprivileged areas. One of the health adverse effects of slum‐dwelling is health care underutilization. Management of type 2 diabetes mellitus (T2DM) requires an appropriate utilization. This study aimed to investigate the extent of health care utilization among slum‐dwellers with T2DM in Tabriz, Iran, in 2022. Methods We conducted a cross‐sectional study on 400 patients with T2DM living in slum areas of Tabriz, Iran. Sampling was conducted using a systematic random sampling method. A researcher‐made questionnaire was used for data collection. To develop the questionnaire, we used Iran's Package of Essential Noncommunicable (IraPEN) diseases, in which potential needs and essential health care for patients with diabetes and the appropriate time intervals for use are specified. Data were analyzed using SPSS version 22. Results Although 49.8% of patients needed outpatient services, only 38.3% were referred to health centers and utilized health services. The results of the binary logistic regression model showed that women (OR = 1.871, CI 1.170–2.993), those with higher income levels (OR = 1.984, CI 1.105–3.562), and those with diabetes complications (Adjusted OR = 1.7, CI 0.2–0.603) were almost 1.8 times more likely to utilize outpatient services. Additionally, those with diabetes complications (OR = 1.93, CI 0.189–2.031) and those taking oral medication (OR = 3.131, CI 1.825–5.369) were respectively 1.9 and 3.1 times more likely to utilize inpatient care services. Conclusions Our study showed that, although slum‐dwellers with type 2 diabetes needed outpatient services, a small percentage were referred to health centers and utilized health services. Multispectral cooperation is necessary for improving the status quo. There is a need to take appropriate interventions to strengthen health care utilization among residents with T2DM living in slum sites. Also, insurance organizations should cover more health expenditures and provide a more comprehensive benefits package for these patients.

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Community‐based health insurance service utilization and associated factors in Addis Ababa, Ethiopia

Girmay

Reta

2022

Public Health Challenges

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Introduction Community‐based health insurance (CBHI) scheme is a powerful tool to achieve universal health service coverage by providing financial protection against healthcare costs. Ethiopia introduced CBHI, although its utilization is suspected to be poor. Consequently, this study aimed to assess CBHI service usage and related factors. Methods Six hundred fifty‐two participants were enrolled in this study. Data was collected through a face‐to‐face interview. Results This study indicated that 60% of respondents utilized the CBHI service. In this study, male participants were 44% less likely to use the CBHI service (AOR = 0.44 with 95%CI: 0.28–0.70) than female participants. Besides, participants from small households were 54% less likely to utilize the CBHI service (AOR = 0.54 with 95%CI: 0.36–0. 82) than those from large families. However, using the CBHI service was 4.97 times higher among illiterate participants (AOR = 4.97 with 95%CI: 1.46–16.91) than those with literacy skills. Moreover, participants with low income were 5.14 times more likely to use the CBHI service (AOR = 5.14 with 95%CI: 2.27–11.64) than those with high monthly income. Additionally, participants who had not a private home were 6.31 times higher to use the CBHI service (AOR = 6.31 with a 95%CI: 2.76–14.46) than those who had. Furthermore, participants having adequate information on the CBHI were 8.99 times more likely to use the CBHI service (AOR = 8.99 with 95%CI: 5.66–14.27) than those who had not. Conclusion The study provides essential information regarding CBHI service utilization and associated factors. Although the majority of the participants used the CBHI service, still a large number of users did not receive the services properly. Availability of laboratory services and delivery of essential drugs were low. Therefore, government and other relevant agencies should develop effective regulatory systems to promote the CBHI service and improve public health facilities' capacity to provide CHHI services properly.

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Community-based health insurance and healthcare service utilisation, North-West, Ethiopia: a comparative, cross-sectional study

Cited by 60 publications

References 21 publications

Factors affecting community based health insurance utilization in Ethiopia: A systematic review

Factors affecting community based health insurance utilization in Ethiopia: A systematic review

Health care utilization and its association with sociodemographic factors among slum‐dwellers with type 2 diabetes in Tabriz, Iran: A cross‐sectional study

Community‐based health insurance service utilization and associated factors in Addis Ababa, Ethiopia

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