Willingness to join and pay social health insurance and associated factors among public sectors workers in Didu Woreda, South West Ethiopia, 2018

Abstract

Background: Social health insurance is a form of healthcare financing mechanism for raising and pooling funds to finance and manage health services to attain universal health coverage. Cost-sharing between beneficiaries and governments is critical to achieving universal health care coverage. To address this, Ethiopia is currently introducing social health insurance.Objective: To assess the willingness and associated factors to join and pay social health insurance among public sectors workers in Didu woreda, southwest Ethiopia,2018Methodology: A cross-sectional study was conducted from April 15-30, 2018 on 280 public sector workers of Didu Woreda. Stratified and simple random sampling techniques were used, and data were collected using a structured interviewer-administered questionnaire. Binary logistic regression analysis was used to compute crude odd ratio with its 95% confidence interval to test the associations between dependent and independent variables and a P-value of 0.05 with a confidence interval of 95% was used to declare the level of statistical significance.Results: 280 public sectors workers participated, with a response rate of 98.2%. About 33.6% of the public servants had never heard of any type of health insurance scheme. However, 47.5% of them were willing to join for the suggested insurance scheme from these about 58% of those who were willing to join are willing to pay 3%of their monthly salary that was proposed. Willingness to join was significantly associated with the age of respondents, marital status, job description, how much paid, the satisfaction of the respondents, and previous history of borrowing money for the medical service fees.Conclusion: willingness to join and pay in this study was found to be 47.5% and 58% respectively. Therefore, adequate awareness creation and discussion should be made with all employees.

Willingness to pay for Social Health Insurance and associated factors among Public Civil Servants in Ethiopia: A systematic review and meta-analysis

“…As indicated in Table 1, 20 cross-sectional studies with a total sample size of 8744 workers were included in this systematic review and meta-analysis. The studies were conducted from 2014 to 2022 and the retrieved studies were from the Southern Nations, Nationalities, and People Region (SNNPR) [18,29], Amhara [13-15, 21, 30-32], Addis Ababa [17,19,20,[33][34][35], Harar [36], Oromia [37] and from Tigray [16,38,39]. The sample size of the study ranged from 218 to 843 participants.…”

“…Thus, we employed a random effect model to estimate the pooled prevalence of WTP for the SHI scheme among workers in Ethiopia. The pooled magnitude of WTP for the SHI scheme in Ethiopia among workers was 49.62% (95% CI: 36.41-62.82) based on the DerSimonian-Laird random-effect model [13][14][15][16][17][18][19][20][21][29][30][31][32][33][34][35][36][37][38][39]…”

“…According to the meta-analysis findings, the odds of paying for the SHI scheme among respondents who had large family members were 3.69 times more likely compared to study participants who had fewer family (AOR 3.69, 95% CI: 1.10, 12.36) (Fig 8). Six studies [14,16,18,21,30,37] were included in the meta-analysis to determine the association between the difficulty of paying medical bills and WTP for the SHI scheme. The odds of paying for the SHI program among those who had difficulty paying bills were almost three times more likely higher compared to their counterparts(AOR 3.24, 95% CI: 1.51, 6.96) (Fig 9).…”

“…According to the findings of a meta-analysis, workers who had favourable attitudes were almost five times more likely to pay for the SHI scheme compared to their counterparts (OR = 5.28, 95% CI: 1.45-19.18) (Fig 10). We used five primary studies to explore the association between respondents' marital status and WTP for the SHI scheme among Ethiopian workers [18,31,33,36,37]. According to a meta-analysis of five primary studies, workers' marital status was not significantly associated with the WTP for the SHI scheme among public workers in Ethiopia (OR = 0.71, 95%CI: 0.36-1.42) (Fig 11).…”