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

Girmay, Aderajew Mekonnen; Reta, Mulumebet Tadesse

doi:10.1002/puh2.18

Cited by 3 publications

(1 citation statement)

References 22 publications

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“…17 The incidence of CHE is particularly high households with member who have cancer. 18,19 Existing limited studies revealed that more than half of households with members who used medical services for cancer incurred catastrophic health expenditures. For instance, a study conducted in Addis Ababa in 2018 revealed that the incidence of CHE among cancer patients was 74.4%.…”

Section: Introductionmentioning

confidence: 99%

Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia

Matebie,

Mebratie,

Demeke

et al. 2024

RMHP

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Background: Out-of-pocket (OOP) health expenditures for cancer care expose households to unanticipated economic consequences. When the available health services are mainly dependent on OOP expenditure, the household faces catastrophic health expenditure (CHE). This study aimed to estimate the incidence and intensity of CHE in hospitalized cancer patients and identify coping strategies and associated factors. Method and Material: Hospital-based cross-sectional study design was conducted on 305 cancer inpatients in Addis Ababa between November 2021 and February 2022. All patients with cancer who were hospitalized during the data collection period were included in the study. The incidence of CHE was estimated at the 40% threshold of households' non-food expenditure and the intensity of CHE was captured based on the amount by which household expenditure exceeded the threshold and mean positive overshoot, the mean level by which CHE exceeds the threshold used. Multivariate logistic regression was used to assess the relationship between CHE levels and the independent variables. Results: The incidence of CHE at the 40% threshold of households' non-food expenditure was 77.7%, while the O and MPO were 36.2% and 46.6%, respectively. CHE for cancer care was significantly associated with patient residence, increased number of chemotherapy cycles, increased duration of hospital admission, lack of insurance enrolment, and lower-income quintiles. Saving and selling assets were identified as the primary coping mechanisms. Conclusion:The incidence and intensity of CHE among inpatients with cancer were high and which could lead to impoverishment of households. Improved quality and coverage of health insurance and decentralizing cancer care to regions standards similar to Addis Ababa will save households from incurring CHE.

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Section: Introductionmentioning

confidence: 99%

Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia

Matebie,

Mebratie,

Demeke

et al. 2024

RMHP

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The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis

Bayked

Toleha

Kebede³

et al. 2023

Global Health Action

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Background Ideally health insurance aims to provide financial security, promote social inclusion, and ensure equitable access to quality healthcare services for all households. Community-based health insurance has been operating in Ethiopia since 2011. However, its nationwide impact on universal health coverage has not yet been evaluated despite several studies being conducted. Objective We evaluated the impact of Ethiopia’s community-based health insurance (2012–2021) on universal health coverage. Methods On 27 August 2022, searches were conducted in Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar. Twenty-three studies were included. We used the Joana Briggs Institute checklists to assess the risk of bias. We included cross-sectional and mixed studies with low and medium risk. The data were processed in Microsoft Excel and analyzed using RevMan-5. The impact was measured first on insured households and then on insured versus uninsured households. We used a random model to measure the effect estimates (odds ratios) with a p value < 0.05 and a 95% CI. Results The universal health coverage provided by the scheme was 45.6% (OR = 1.92, 95% CI: 1.44–2.58). Being a member of the scheme increased universal health coverage by 24.8%. The healthcare service utilization of the beneficiaries was 64.5% (OR = 1.95, 95% CI: 1.29–2.93). The scheme reduced catastrophic health expenditure by 79.4% (OR = 4.99, 95% CI: 1.27–19.67). It yielded a 92% (OR = 11.58, 95% CI: 8.12–16.51) perception of health service quality. The health-related quality of life provided by it was 63% (OR = 1.71, 95% CI: 1.50–1.94). Its population coverage was 40.1% (OR = 0.64, 95% CI: 0.41–1.02). Conclusion Although the scheme had positive impacts on health service issues by reducing catastrophic costs, the low universal health coverage on a limited population indicates that Ethiopia should move to a broader national scheme that covers the entire population.

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Exploring Factors Influencing Family’s Membership in Community-Based Health Insurance in the City of Gondar Peri-Urban Area, Northwest Ethiopia: A Health Belief Model Approach

Melkamu,

Melkamu

2024

Preprint

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Background- A research gap exists in finding practical solutions to provide affordable and accessible health insurance coverage to improve CBHI membership and sustainability to people in resource-poor settings and contribute to achieving universal health coverage (UHC) in Ethiopia. This research was initiated to analyze the role of health choice to identify significant factors based on the health belief model (HBM) by providing a theoretical framework for understanding individual health-related behavior and developing effective interventions to promote participation in health insurance programs. Methods- Cross-sectional information was gathered from 358 families, and original facts were utilized. Descriptive and Binary logistics in the econometric model were applied for data analysis. Findings- The descriptive findings demonstrated that except for sex, religion, nuclear family largeness, and job occupation variables, other variables established a significant Consequence. The results of the logistic regression model showed that the distance of the nearest health station from the family’s home in a minute [AOR (95% CI) = .177 (.015, − .399)], being a member of the families having an official position in local government or cultural structure [AOR (95% CI) = .574 (.355, .793)], having an experience of visiting health facilities [AOR (95% CI) = .281 (.166, .396)], and perceiving the local CBHI scheme management as trustworthy [AOR (95% CI) = .404 (.233, .575)] were positively associated with family enrollment in the CBHI scheme. On the other hand, being a member of the “rotating saving and credit association” (ROSCA) [AOR (95% CI) =-.299 (-.478, − .120)] was negatively associated with the family’s enrollment in the CBHI scheme. Conclusion- Institutional variables, trust in CBHI scheme management, and family’s experience of visiting health facilities and distance from the nearest health station were essential factors influencing enrollment, whereas “Rotating saving and credit association” (ROSCA) º negatively and statistically significantly impacted and income level was not associated with membership.

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

Cited by 3 publications

References 22 publications

Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia

Catastrophic Health Expenditure and Associated Factors Among Hospitalized Cancer Patients in Addis Ababa, Ethiopia

The impact of community-based health insurance on universal health coverage in Ethiopia: a systematic review and meta-analysis

Exploring Factors Influencing Family’s Membership in Community-Based Health Insurance in the City of Gondar Peri-Urban Area, Northwest Ethiopia: A Health Belief Model Approach

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