Willingness to join community-based health insurance among rural households of Debub Bench District, Bench Maji Zone, Southwest Ethiopia

Abstract

BackgroundEven though Ethiopia bears high burden of diseases, utilization of modern health care services is limited. One of the reasons for low utilization of healthcare services is the user-fee charges. Moving away from out-of-pocket charges for healthcare at the time of use is an important step towards averting the financial hardship associated with paying for health service. Prepaid plans for health are not accustomed in Ethiopia. Therefore, social and community based health insurance schemes were introduced since 2010.In this study, willingness of rural households in Debub Bench District, to join community based health insurance was assessed.MethodCross-sectional community based study was conducted in Debub Bench District in March 2013 using a pretested structured questionnaire. Two stage sampling technique was used to select 845 households as study units which were allocated to the kebeles proportionately. The sampled households were selected using simple random sampling technique. Data were entered into EPIDATA 3.0 and analyzed with SPSS version 20.ResultAmong 845 sampled households, 808 were interviewed (95.6% response rate). About 78% of the respondents were willing to join the scheme. Most of demographic, socioeconomic variables and social capital were found to be significantly associated with willingness to join community based health insurance.ConclusionIf the scheme is initiated in the district, majority of the households will enroll in the community based health insurance. Farmers, the married households, Bench ethnic groups and illiterate, the dominant segments of the population, are more likely to enroll the schemes. Therefore initiation of the scheme is beneficial in the district.

Adverse selection and supply‐side factors in the enrollment in community‐based health insurance in Northwest Ethiopia: A mixed methodology

“…Household head's educational status has a significantly positive effect on the decision of enrollment in CBHI. This result is in line with study findings about willingness to join CBHI in Ethiopia, enrollment studies in Kenya, Bangladesh, Vietnam, India, Burkina Faso, and Lao PDR, which indicate the relationship between educational status of the household head and health insurance enrollment. This can be justified as an educated household head is expected to have better knowledge and understanding about the effects of illness on health care expenditure, which leads them to make a rational decision and join insurance to minimize out of‐pocket payments.…”

Inequitable Access to Health Care by the Poor in Community-Based Health Insurance Programs: A Review of Studies From Low- and Middle-Income Countries

“…A 2007 cross-sectional survey in southwest Ethiopia found that households in the highest quintile were 2.7 times more willing to join a CBHI program than families in the lowest quintile 31 . A more recent survey in southwest Ethiopia in 2013 showed that households in the highest wealth quintile were more than 4 times more willing to join the CBHI compared with households in the second wealth quintile 29 . Similarly, Asfaw et al found that a 1% increase in income in rural Ethiopia led to an 8.4% increase in the probability of willingness to pay for health insurance 30 .…”

Factors affecting the willingness to join community‐based health insurance (CBHI) scheme: A case study survey from Savannakhet Province, Lao P.D.R.

“…This finding contradicts a previous study conducted in Ethiopia, which revealed that most of the demographic variables such as age, marital status, occupation, household size, ethnicity, and the respondent's relationship with the head of household were significantly associated with WTJ the CBHI scheme in Debub Bench district, Bench Maji Zone, Southwest Ethiopia. Specifically, the respondent's age had a negative relationship with the household's WTJ, the possible reason being that, unlike the Laos CBHI scheme, and many other CBHI schemes, the scheme operated in Ethiopia covered only household members aged below 18 years of age. On the other hand, other studies found that age and incentive for enrolling in the scheme were positively associated with the WTJ the CBHI scheme.…”