Determinants of enrollment in community based health insurance among Households in Tach-Armachiho Woreda, North Gondar, Ethiopia, 2019

Muluken Genetu Chanie · Gojjam Eshetie Ewunetie

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Healthcare Systems and Reforms Healthcare Policy and Management Public Health and Social Inequalities

Abstract

BACKGROUND: Recently in Ethiopia, there is an increasing movement to implement community based health insurance scheme as integral part of health care financing and remarkable movements has resulted in the spread of the scheme in different parts of the country. Despite such increasing effort, recent empirical evidence shows enrolment has remained low. To identify determinants of enrollment in community based health insurance among households in Tach-Armachiho Woreda, North Gondar, Ethiopia, 2019. METHODS: A community based unmatched case control study was conducted Tach-Armachiho Woreda from March to May 2019 among 262 participants (88 cases and 174 controls with case control ratio of 1:2). Study subjects were selected using multi-stage sampling technique. Data were collected using a pretested, structured interviewer administered questioner. Data were entered to Epi-info 7 and exported to SPSS version 20 for analysis. Bivariable and multivariable logistic regression model were used to see the determinants of enrollment in community based health insurance. Adjusted odds ratio with 95% CI at p-value <0.05 in multivariable logistics regression analysis factors were identified as statistically significantly associated. RESULT: Female headed households (AOR = 2.79, 95% CI = 1.16, 6.69), Increase in Age (AOR = 1.09, 95% CI = 1.05, 1.13) and negative perception towards community based health insurance (AOR = 0.062, 95% CI = .030, .128) were found to be significant predictors. CONCLUSION: This study provides evidence that the decision to enroll in the scheme is shaped by age and a combination of household head sex and perception towards community based health insurance. Implementers aimed at enhancing enrolment ought to act on the bases of this findings.

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2010Health systems financing and the path to universal coverage 2008Coping with out-of-pocket health payments: empirical evidence from 15 African countries 2016What Factors Affect Voluntary Uptake of Community-Based Health Insurance Schemes in Low- and Middle-Income Countries? A Systematic Review and Meta-Analysis 2015A systematic review of factors that affect uptake of community-based health insurance in low-income and middle-income countries 2011Household perceptions and their implications for enrolment in the National Health Insurance Scheme in Ghana 2008The effect of community-based health insurance on the utilization of modern health care services: Evidence from Burkina Faso 2009Willingness to pay for community-based health insurance in Nigeria: do economic status and place of residence matter?2006Understanding enrolment in community health insurance in sub-Saharan Africa: a population-based case–control study in rural Burkina Faso

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