The Impact of Community-Based Health Insurance on Household's Welfare in Chilga District, Amhara Regional State, Ethiopia

Asfaw, Dagmawe Menelek; Shifaw, Sirage Mohammed; Belete, Atinkugn Assefa; Aychiluhm, Setognal Birara

doi:10.3389/fpubh.2022.868274

Cited by 5 publications

(4 citation statements)

References 36 publications

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“…The probability of using health services was 8 times among family with chronic disease among insured HHs compared with 4.9 times in NI HHs than their counterparts. Studies done in Kenya 33 and the South Gondar Zone Northwest, Ethiopia, 30 the South Gondar Zone 34 and Chilga District, 35 support this study’s findings. This could be due to the presence of adverse selection, in which the higher the presence of chronic disease, the higher the chance of being insured in CBHI.…”

Section: Discussionsupporting

confidence: 84%

What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study

Terefa,

Geta,

Shama

et al. 2024

BMJ Open

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ObjectiveIn Ethiopia, despite increased health service coverage, health service utilisation remains very low. However, evidence on the level of health service utilisation between insured and non-insured households in the study area was scanty. Therefore, this study aimed to assess health service utilisation and its predictors among insured and non-insured households of community-based health insurance in the East Wallaga Zone, Oromia region, Ethiopia, in 2022.MethodsA community-based comparative cross-sectional study was employed. Data were collected using semi-structured interviewer-administered pretested questionnaire by face-to-face interviewing of heads of the households or spouse from 1 January 2022 to 30 January 2022, on 900 (450 insured and 450 non-insured). Epi-Data V.3.1 and Statistical Package for Social Science V.26 were used for data entry and analysis, respectively. The association between dependent (health service utilisation) and independent variables was analysed first using binary logistic regression. Multivariable logistic regression was used to identify potential predictor variables at a p<0.05.ResultsAbout 60.5% (95% CI 55.7% to 64.8%) of insured households had used health services compared with 45.9% (95% CI 41.4% to 50.9%) of non-insured households in the last 6 months. Family health status (Adjusted Odd Ratio (AOR) and 95% CI=2.74 (1.37 to 5.45), AOR and 95% CI=1.62 (1.01 to 3.14)); family with chronic disease (AOR and 95% CI=8.33 (5.11 to 13.57), AOR and 95% CI=4.90 (2.48 to 9.67)); perceived availability of drugs (AOR and 95% CI=0.34 (0.15 to 0.79), AOR and 95% CI=3.97 (1.69 to 9.34)); perceived transportation cost (AOR and 95% CI=0.44 (0.21 to 0.90), AOR and 95% CI=1.71 (1.00 to 2.93)); participated in indigenous community insurance (AOR and 95% CI=3.82 (1.96 to 7.45), AOR and 95% CI=0.13 (0.06 to 0.29)) and >10 km travel distance from nearby health facilities (AOR and 95% CI=1.52 (1.02 to 2.60), AOR and 95% CI=8.37 (4.54 to 15.45)) among insured and non-insured households, respectively, were predictors of health service utilisation.ConclusionInsured households were more likely to utilise health services compared with non-insured households. Family health status, family with chronic disease, perceived availability of drugs, perceived transportation cost, participation in indigenous community insurance and >10 km travel were predictors of health service utilisation among insured and non-insured households. Hence, the greatest emphasis should be given to enhancing enrolment in the community-based health insurance scheme to achieve universal health coverage.

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Section: Discussionsupporting

confidence: 84%

What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study

Terefa,

Geta,

Shama

et al. 2024

BMJ Open

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“…As such, it reduced OOP [ 55 ], CHE [ 45 , 57 , 58 ], and COC [ 49 ]. In doing so, it improved household welfare [ 59 ]. HSQ : CBHI has contributed to the provision of HSQ [ 55 , 60 ].…”

Section: Resultsmentioning

confidence: 99%

“…As such, it reduced OOP [ 55 ], CHE [ 45 , 57 , 58 ], and COC [ 49 ]. In doing so, it improved household welfare [ 59 ].…”

Section: Resultsmentioning

confidence: 99%

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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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Patterns of enrollment to community-based health insurance and the situations influencing utilization of the services in Southern Ethiopia: a qualitative study

Siraw,

Zewude,

Meshesha

2024

Cogent Public Health

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The Impact of Community-Based Health Insurance on Household's Welfare in Chilga District, Amhara Regional State, Ethiopia

Cited by 5 publications

References 36 publications

What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study

What role does community-based health insurance play in the utilisation of health services among households in Ethiopia? A community-based comparative cross-sectional study

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

Patterns of enrollment to community-based health insurance and the situations influencing utilization of the services in Southern Ethiopia: a qualitative study

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