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

Background: Social Health Insurance is a system of financing and managing health care of employees. A million people suffer a health-related financial catastrophe each year, and the majority have difficulty paying health expenditures, which leads government employees to low health service utilization. However, there is no evidence of the status of health insurance in the study area. Therefore, the study aimed to assess willingness to pay for social health insurance and associated factors among government employees, in Jigjiga town, eastern Ethiopia. Method: A mixed method cross-sectional study was used among 578 randomly selected government employees from March 30 to May 30, 2023, in Jigjiga city. Data was collected using a pre-tested semi-structured questionnaire through self-administration, entered into Epi-data version 3.1, and exported to SPSS version 22.0. Binary logistic regression was conducted to identify factors associated with willingness to pay. An odds ratio with a 95% confidence interval was used to interpret the finding and statistical significance was set at p < 0.05. Nine in-depth interviews were used to collect qualitative data, which were then analyzed thematically. Results: Willingness to pay for social health insurance was 69.90%. Factors such as age >39 years old [AOR=6.30, 95 % CI;2.23,17.86], masters and above educational [AOR=0.41, 95% CI; 0.17,0.98], family size >=5 [AOR=0.11, 95% CI; 0.03,0.39], chronic illness in a family [AOR=0.37, 95 % CI; 0.25,0.55], and belief social health insurance as no benefit [AOR= 0.26, 95 % CI; 0.08,0.85] were significantly associated with social health insurance. From in-depth interviews, social health insurance has high acceptance and is considered an appropriate program for the study area. Conclusion: Nearly seven out of ten government employees are willing to pay for the proposed SHI. Age, educational status, family size, presence of chronic disease, and belief in SHI benefits are associated with willingness. A strong emphasis on implementation and providing necessary information for employees should be given to enhance their knowledge. It would be better to advocate the SHI for policymakers in order to start early implementation of the SHI in the Somali region.

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Willingness to pay for social health insurance in Ethiopia: A systematic review and meta-analysis

Bayked

Toleha

Chekole

et al. 2023

Front. Public Health

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BackgroundEthiopia plans to introduce social health insurance with the aim of giving recipients high-quality, long-term universal health care. It was anticipated to be fully operational in 2014. However, due to strong opposition from public employees, the implementation has been delayed multiple times. As a result, more and more studies have been conducted to collect evidence about the issue. However, there is no national pooled evidence regarding the willingness to pay for the scheme. Thus, this review aimed to evaluate the willingness to pay for social health insurance and associated factors in Ethiopia.MethodsOn September 1, 2022, database searches were conducted on Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar. Based on this search, 19 studies were included in the review. The risk of bias for the included studies was assessed using Joana Briggs Institute checklists. The data were extracted using Microsoft Excel. RevMan-5 was used to conduct the meta-analysis. The effect estimates assessed were the odds ratios at a p-value <0.05 with a 95% CI using the random effect model.ResultsThe pooled willingness to pay for social health insurance was 42.25% and was found to be affected by sociodemographic, health and illness status, health service related factors, awareness or knowledge level, perception or attitude toward the scheme, and factors related to the scheme. The pooled result showed that the willingness of participants to pay for the scheme was 16% less likely (OR = 0.84; 95% CI: 0.52–1.36). When the outlier was unchecked, the willingness to pay became 42% less likely (OR = 0.58; 95% CI: 0.37–0.91). The lowest willingness to pay for the scheme was in the Oromia region, while the highest was in Harar. Professionally, teachers were 3.22 times more likely to pay for the scheme (OR = 3.22; 95% CI: 1.80–5.76) than health professionals.ConclusionThe willingness to pay for social health insurance was low, <50%, particularly among health professionals, which urges the Ethiopian health insurance service to deeply look into the issue.

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

Cited by 3 publications

References 9 publications

Analysis of Influencing Factors of Medical Insurance Participation Willingness of Middle-Aged and Elderly Residents with Chronic Disease Comorbidities—A Quantitative Analysis Based on Binary Logistic Regression and Decision Tree Model

Analysis of Influencing Factors of Medical Insurance Participation Willingness of Middle-Aged and Elderly Residents with Chronic Disease Comorbidities—A Quantitative Analysis Based on Binary Logistic Regression and Decision Tree Model

Willingness to pay for social health insurance and associated factors among government employees in Jigjiga, Eastern Ethiopia: Mixed Method Study

Willingness to pay for social health insurance in Ethiopia: A systematic review and meta-analysis

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