Teachers’ Willingness to Pay for Social Health Insurance and Its Determinant Factors at Harar Region, Ethiopia, 2021

Abstract

Background: Most developing nations lag behind in maintaining their populations' health. These nations are characterized by underfinancing, low health cost protection mechanisms for the poor, and lack of risk pooling and cost sharing methods. To tackle this challenge, Ethiopia proposed social health insurance in 2010 even though its implementation was delayed. Hence, the purpose of this study was to assess teachers' willingness to pay for the newly proposed social health insurance and its associated factors. Methods: A cross-sectional study was conducted and a stratified sampling technique was used to select government and private schools. After data were collected using a semi-structured self-administered questionnaire, binary and multivariate logistic regressions were done to examine determinants of willingness to pay for social health insurance. Results: Among participants who faced illness six months prior to the study, 85.7% reported that they paid "out of their pocket". About 59.2% and 54% of the teachers had a positive attitude and good knowledge toward health insurance schemes respectively. Of the total study respondents, 89.5% were willing to pay for the suggested insurance scheme. Forty eight percent of participants agreed to pay greater than or equal to 4% of their monthly salary. Willingness to pay was more likely among those who taught in secondary schools, had a positive attitude and good knowledge. Conclusion:Nearly three fourths of the teachers showed willingness to pay for social health insurance. Participants with good knowledge, a positive attitude and from primary schools were more likely to be willing to pay for social health insurance. Equipping all public facilities' employees with necessary knowledge of social health insurance is essential to reduce catastrophic health care costs. Future researchers need to consider qualitative studies to support these findings.

Social Health Insurance and Healthcare Seeking Behavior in Urban Ethiopia

“…For instance, in Mekelle, the largest city in the country's Tigray region, a majority (85%) of the 381 public servants were willing to be part of the social health insurance scheme, with a mean WTP of 3.6% of their monthly salary [18]. Although not as high as in Mekelle, surveys amongst teachers in Harar, Wolaita Sodo, Gondar and Akaki Kality (a sub-city of Addis Ababa), yielded WTP rates of between 62% and 74% [19][20][21][22]. A meta-analysis covering 18 studies showed that, on average, about 42% of formal sector workers are WTP for SHI [23].…”