Community-Based Health Insurance Utilization and Its Associated Factors among Rural Households in Akaki District, Oromia, Ethiopia, 2021

Geferso, Amenti Teka; Sharo, Sisay Begashaw

doi:10.1155/2022/9280269

Cited by 12 publications

(13 citation statements)

References 34 publications

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“…This finding is consistent with those from other settings elsewhere [ 29 – 31 ], which shows the richest households were more likely to use the CBHI program when compared the poorest households. In addition, it is in line with the previous studies [ 26 , 28 , 32 , 33 ], which show income significantly positively affected CBHI enrollment. This study was not in line with the previous studies [ 34 ], poor wealth status households were more likely willing to pay/enroll for CBHI than rich household heads.…”

Section: Discussionsupporting

confidence: 92%

“…This study also revealed that households with 4 up to 6 members were more likely to enroll in the CBHI scheme than households with 1 up to 3. This study was consistent with the previous studies [ 28 , 38 ], which show family size had a significant positive effect on dropout of households from the CBHI scheme This study contradicts the previous study [ 26 , 32 , 39 ], which shows family size had a significant negative effect on CBHI enrollment. Moreover, this study was not in line with the study [ 31 ], which shows the number of family sizes in the household had no significant effect on CBHI enrollment.…”

Section: Discussionsupporting

confidence: 89%

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The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia

2022

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Introduction Community-based health insurance (CBHI) is a type of volunteer health insurance that has been adopted all over the world in which people of the community pool funds to protect themselves from the high costs of seeking medical care and treatment for the disease. In Ethiopia, healthcare services are underutilized due to a lack of resources in the healthcare system. The study aims to identify the individual and community level factors associated with community-based health insurance enrollment of households in Ethiopia. Methods Data from the Ethiopian mini demographic and health survey 2019 were used to identify factors associated with community-based health insurance enrollment of households in Ethiopia. Multilevel logistic regression analysis was used on a nationally representative sample of 8,663 households nested within 305 communities, considering the data’s layered structure. We used a p-value<0.05 with a 95% confidence interval for the results. Result The prevalence of community-based health insurance enrollment in Ethiopia was 20.2%. The enrollment rate of households in the scheme was high in both Amhara (57.9), and Tigray (57.9%) regions and low (3.0%) in the Afar region. At the individual level; the age of household heads, number of children 5 and under, number of household members, has land for agriculture, has a mobile telephone, receiving cash of food from the safety Net Program, Owning livestock, and herds of farm animals, wealth index, and at the community level; the region had a significant association with community-based health insurance enrollment. Conclusion Both individual and community-level characteristics were significant predictors of community-based health insurance enrollment in households. Furthermore, the ministry of health, health bureaus, and other concerning bodies prioritize clusters with low health insurance coverage to strengthen health system financing and intervene in factors that negatively affect the CBHI enrollment of households.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 89%

The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia

2022

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“…The studies were conducted from 2017 to 2022. Regarding the distribution of the studies across the region, five were from Amhara [ 40 , 41 , 43 , 45 , 47 ], four from Oromia [ 34 , 35 , 44 , 46 ], two from Sidama [ 39 , 42 ], one from Somali [ 37 ], one from Southern Nations, Nationalities, and Peoples’ Region (SNNPR) [ 36 ], and two from Addis Ababa [ 38 , 48 ]. In all of the studies, data was collected by a face-to-face interview using a pretested, interviewer-administered questionnaire ( Table 1 ).…”

Section: Resultsmentioning

confidence: 99%

“…Fifteen studies (11 cross-sectional and 4 case-control) with a total of 8418 study participants were considered [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48]. Both the minimum (n = 262) [41] and the maximum(n = 1014) [43] sample size were from the Amhara region.…”

Section: Characteristics Of Included Studiesmentioning

confidence: 99%

Towards universal health coverage: The level and determinants of enrollment in the Community-Based Health Insurance (CBHI) scheme in Ethiopia: A systematic review and meta-analysis

Habte¹,

Tamene²,

Ejajo³

et al. 2022

PLoS ONE

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Background Community-based health insurance (CBHI) is a risk-pooling approach that tries to disperse health expenditures across families with varying health profiles to provide greater access to healthcare services by allowing cross-subsidies from wealthy to poor populations. It is crucial to assess the level of CBHI enrolment and its determinants in Ethiopia, where government health spending is limited to less than 5% of GDP, far below the Alma Ata Declaration’s benchmark of 15%. Although various epidemiological studies on CBHI enrolment status and its determinants have been undertaken in Ethiopia, the results have been inconsistent, with significant variability. However, no nationwide study assessing the pooled estimates exists today. Furthermore, the estimated strength of association at the country level varied and was inconsistent across studies. Hence, this systematic review and meta-analysis aimed at estimating the pooled prevalence of CBHI enrolment and its determinants in Ethiopia. Methods A comprehensive search of studies was done by using PubMed, EMBASE, Science Direct, HINARI, Scopus, Web of Science, and the Cochrane Library. The database search was complemented by google scholar and some repositories for grey literature. The search was carried out from February 11 to March 12, 2022. The relevant data were extracted using a Microsoft Excel 2013 spreadsheet and analyzed using STATATM Version 16. Studies reporting the level and determinants of CBHI enrolment in Ethiopia were considered. A weighted DerSimonian Laired random effect model was applied to estimate the pooled national prevalence of CBHI enrolment. The Cochrane Q test statistics and I2 tests were used to assess the heterogeneity of the included studies. A funnel plot, Begg’s and Egger’s tests, were used to check for the presence of publication bias. Results Fifteen studies were eligible for this systematic review and meta-analysis with a total of 8418 study participants. The overall pooled prevalence of CBHI enrolment in Ethiopia was 45.5% (95% CI: 32.19, 58.50). Affordability of premium for the scheme[OR = 2.58, 95% CI 1.68, 3.47], knowledge of respondents on the CBHI scheme[OR = 4.35, 95% CI 2.69, 6.01], perceived quality of service[OR = 3.21, 95% CI 2.04, 4.38], trust in the scheme[OR = 2.32, 95% CI 1.57, 3.07], and the presence of a person with a chronic disease in the household [OR = 3.58, 95% CI 2.37, 4.78] were all found to influence CBHI enrolment. Conclusion Community health workers (CHWs) need to make a high effort to improve knowledge of CBHI in rural communities by providing health education. To deal with the issue of affordability, due emphasis should be placed on building local solidarity groups and strengthening local initiatives to aid poor members. Stakeholders in the health service delivery points need to focus on the dimensions of high service quality. The financial gap created by the adverse selection of households with chronically ill members should be rectified by implementing targeted subsidies with robust plans.

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“…Although equity to health service is the underlying principle of major global public health strategies such as the health sector reforms spearheaded by the World Bank and the current Sustainable Development Goals (SDGs) 3, its implementation is a significant public health challenge [3,5]. Many studies revealed that several low-income countries are challenged to sustain healthcare financing [6,7]. However, achieving universal health coverage, including financial risk protection, access to quality healthcare services, and access to safe, adequate, quality, and affordable essential medicines are fundamental for sustaining growth and development [8].…”

Section: Introductionmentioning

confidence: 99%

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 Utilization and Its Associated Factors among Rural Households in Akaki District, Oromia, Ethiopia, 2021

Cited by 12 publications

References 34 publications

The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia

The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia

Towards universal health coverage: The level and determinants of enrollment in the Community-Based Health Insurance (CBHI) scheme in Ethiopia: A systematic review and meta-analysis

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

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