A Study on the Feasibility of Health Insurance Schemes for Community based Groups' in Addis Ababa City: A Case Study of "IDDIRS".
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Date
2010-05
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A.A.U
Abstract
The current health financing practice in Ethiopia demands that part of the cost be covered through out-of pocket
user fees al the lime of sickness. The inadequacy of current health financing arrangements, typified
by progressively declining budgetary allocations implies the need t0 explore alternative approaches to
improve the financing situation. Community Based Health Insurance scheme (CEHIs) is being seen as a
Promising new /001 for health system improvement in low income countries, particularly in Sub-Saharan
Africa. The successful implementation of this Community Eased Health Insurance depends on the capacity
and willingness of the community t0 regularly pay their contribution/premium. Given the high level of
poverty in Ethiopia expansion of CEHIs could face serious challenge as the premium could be beyond the
ability of the majority of the urban and rural poor.
This study analyses the feasibility of CEHIs provision for a community based organizations called adders
by determining the member households ' willingness 10 pay for the proposed scheme. Three adders are
purposively selected from areas that are believed t0 constitute largely of the low income earning and also
informally employed groups of the society in the capital city, Addis Ababa. From the three adders 210
households were systematically sampled for an interview. A closed ended WTA question followed by an
open ended WTP question under hypothetical CEHIs was presented for the respOndel7/S to elicit their
maximum willingness to pay amounts. The value member households 'attach to the proposed health
insurance is estimated using the contingent valuation method (CVM).
The resells show that the mean willingness to pay amount for the open ended question under the proposed
CEHIs scheme is 11.56 birr per month. This amount of WTP even from the low income earning groups of
the society shows that CEHIS can help to generate sufficient amount of resource that can finance the
deficit of the health sector of the country without evicting the poor and those informally employed section
of the population from the health care market. According to the results from the to bit model income,
secondary and tertiary education dummies, status of the respondent in the household, case of chronic
disease in the household, occupation of the head and size of the household have a positive and significant
effect on the amount of WTP. The probate model shows that age, marital status, respondents status, income
of the household, health care need, size of the household and occupation of the head (all of them with a
positive sign) and the bid price with a negative sign, have a significant effect on the probability of
accepting the bid. The setting of premium prices should consider the ability of pay men I and the willingness
10 pay of households so as 10 assure the sustainable provision of the scheme. Public awareness should be
adequately enhanced on the functioning of the schemes and also the benefits that can be gained from it so
that the service can insure a wider coverage.
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Keywords
A Study on the feasibility, health Insurance