Determinants of Dropout from Community Based Health Insurance Among Household Heads in Sodo Zuria Woreda, Southern Ethiopia 2023
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Date
2023
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Addis Ababa University
Abstract
Background: Ideally, large adoption and renewal rates for the schemes were expected.However, practically, the uptake rates are low, and due to different factors, the dropout ratecould threaten its achievement and sustainability. This later on brought the community back to paying from their pockets for healthcare expenses. Therefore, this study evaluated the reasons why households dropout from community-based health insurance in Sodo Zuria Woreda,Southern Ethiopia.
Methods: A cross-sectional community-based study was conducted by mixing quantitative
and qualitative data collection methods. For the purpose of selecting samples, a multistage sampling procedure was used, which were then proportionally allotted to the number of study households. Factors with a P-value of 0.05 or less were deemed to have a statistically significant association with the dropout of the program after descriptive statistics and logistic regression analyses had been carried out. Thematic analysis, however, is employed to analyzequalitative data.
Results: Overall, out of 591 households, 34.45% dropped out of the CBHI scheme. Young age-adjusted odds ratio (AOR (95% CI) = 0.498 (0.263–0.944)), uneducation/illiterate (AOR(95% CI) = 0.377 (0.212–0.671)), unaffording the premium [AOR (95% CI) = 1.52 (1.04–2.03)], and underutilizing the health service (AOR (95% CI) = 2.16 (1.46–3.18)) were
statistically significant determinants associated with dropout.
Conclusions: Drop out of CBHI is most commonly associated with young age of households,uneduced households, poor knowledge toward the scheme, poor perceived health service quality, and low trust in scheme mangers. By reasons they had to decide to discontinue their membership, and these factors were likewise linked to community-based health insurance dropout.
Recommendations: It was discovered that a considerable number of the respondents were unfamiliar with the scheme's premise. This implies that the concerned groups must continue to raise knowledge and develop concepts for the scheme and insurance