Assessment Of Ethiopian Community Based Health Insurance at South Achefer Woreda, W/Gojjam, Amhara Regional State

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Addis Ababa University


The problems of translating economic growth in to improved health and the inability to finance the health sector without affecting the poor in accessing health services begets a set of social policies required to promote health. One alternative to covering poor people in the informal sector is community-based health insurance (CBHI) schemes. Community-based health insurance development is a potential strategy to meet the urgent need for hea lth financing in lowincome countries. Currently Ethiopian Community Based Hea lth In surance scheme is adopted in a selected thirteen woredas of four regions (Tigray, Amhara, Oromia and SNNP) as a first pilot program. The program at South Achefer woreda is severely affected by the inefficiencies of the health centers, administrative complexity, low enrolment ratio and under representation of the poor. This study is aimed to assess the performance of Ethiopian Community Based Health Insurance at South Achefer Woreda. In doing so both quantitative and qualitative research approaches is employed. Ensuring equity in enrollment thro ugh identification of and premium exemptions for individuals and grou ps without adequate financial resources to pay referred to as indigents or the "poorest of the poor", is one of the stated goals of the Ethiopian CBHI. The identi ficat ion and selection of the poorest of the poor is participatory. The CBHI management board does not have any mechanism to check whether or not these households really are ' ultra poor', The program is financiall y sustainable for 20 I 1/ 12 and 2012113 years at the woreda. But the scheme was financially viable 2011112 than 2012113 or the scheme at the woreda is fin ancially viable at the decreasing rate. Ethiopian CBHI members at South Achefer Woreda explained th at, compared to the previous period when they were not in sured, they visited health facilities more often because all the financial barri ers to the health serv ice is removed. Payment problem, gender of the household head, net income, chronic medication, administrative complexity and education of the household head are statistica lly sign ificant facto rs th at affect the insurance intake decision of household heads at the study area.



Health Insurance