Household satisfaction with a community-based health insurance scheme in Ethiopia

Abstract

BackgroundCommunity-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty. In Ethiopia, CBHI is being piloted in 13 districts, but community experience and satisfaction with the scheme have yet to be studied. Therefore, this study aimed to assess the experiences and satisfaction of households enrolled in a pilot CBHI scheme.MethodsA community-based cross-sectional study method was used in one pilot district in South Ethiopia. Data were collected in March and April 2014. 386 households enrolled in the CBHI scheme were sampled by simple random sampling. Data were collected by trained data collectors using a pre-tested structured questionnaire. Descriptive statistics and bivariate and multiple linear regression analyses were performed. P values less than 0.05 and 95 % confidence intervals were used to determine associations between independent and dependent variables.ResultsThe study revealed that overall household satisfaction with CBHI was 91.38 %. Moreover, there was a significant association between health service provision and CBHI members’ satisfaction scores. For instance, household heads that strongly disagreed with laboratory services provision had an average 0.878 decrease in CBHI satisfaction score compared to household heads that strongly agreed. CBHI process- and management-related factors were also significantly associated with satisfaction.ConclusionsSatisfaction with CBHI was high. Age, family size, laboratory services provision, health services provider friendliness, CBHI offices opening times, membership card collection process, and time interval to use of services were significant predictors of satisfaction with CBHI.

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

“…The health professionals' job satisfaction is negatively related with the health sector reform [56]. Service hour and efficiency of CBHI service were found to be positively associated with satisfaction of CBHI scheme [57], work load without additional incentives negatively affects CBHI utilization [19]. Most of the health institutions were not ready to CBHI scheme's requirements/criteria [58].…”

“…On the other hand, being female was found to be positively associated with the willingness to join (WTJ) to CBHI [15,21,37]. Age was also found to be a positive predictor to CBHI utilization [36,43,44,46,48,57,60]. It was also found to be a negative predictor to the scheme's utilization [17,20,37,40,61].…”

“…It was also found to be a negative predictor to the scheme's utilization [17,20,37,40,61]. Being aged was positively related with the WTJ [36], enrolment to [43,44,48], utilization of [46] and WTP for [57,60] CBHI. But, it was also found that age was a negative predictor to enrolment to [20], WTJ [37], WTP for [40], compliance with [17], and knowledge, attitude and practices of [61]CBHI scheme.…”

“…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]. 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.…”

Does JKN Member’s Satisfaction on Healthcare Services Correlate with Sustainability of Premium Payment? Evidence from the Behavior of Self-Enrolled Member in Greater Jakarta Area

“…There was a different behavior of premium payment between those reported satisfied and The 3rd IMOPH & the 1st YSSOPH non-satisfied to healthcare services. Although this study could not identify reasons for different behavior, another research in a community based health insurance result mentioned that in Ethiopia, process and management were significantly associated with satisfaction determined by office opening times, the membership card collection process, waiting time (length of time between registration and use of the service), and amount of payment, which were all positively associated with satisfaction [14]. Another study in India's national health insurance scheme implied that there was slightly less satisfactory services provided by doctors and nurses affect satisfaction to the healthcare services [15].…”