Assessment of factors Influencing Enrollment of Community-based Health Insurance Scheme in Amaro District of SNNPR, Ethiopia, in 2020
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Date
2021-01
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Addis Abeba University
Abstract
Background: In Ethiopia out of pocket health expenditure is high risking to impoverishment,
inequitable access and utilisation of health care. To curb this government has developed a
health insurance policy to improve financial access, quality and health care coverage. To
solve these problems, to successfully implement the community-based health insurance in the
district and nearest districts there exists a thin layer of evidence. Nevertheless, evidence on
factors that influence households to actively utilizing health insurance of the program is
unknown that makes sustainability and effectiveness of the program in question.
Objective: To assess factors influencing enrollment of community-based health insurance
scheme in Amaro District of SNNPR, Ethiopia in 2020.
Methods: A community-based cross sectional study design was used among randomly
selected 389 households. Binary logistic regression analysis was applied to compute crude
odds ratio with its 95% confidence interval to test the associations between dependent and
independent variables. Then variables found to have P<0.25 in the bi-variate analysis was
taken as candidate for multivariable analysis. A P-value of 0.05 with a confidence interval of
95% was used to declare level of statistical significance.
Results: The prevalence of community-based health insurance enrolment was 20.3% [(95%
CI:[ 23.8, 31.2)].Covariates like: Relatively older ages [ (AOR:3.7; 95% CI:[ 0.07,10) ],
formal education [(AOR:1.3; 95% CI:[ 3.6,34)], non farmers [(AOR : 3 ; 95% CI: [0.9, 80)]. and agree on affordability of premium [(AOR: 0.6 95% CI:[ 0.02, 1.842)], good knowledge
on CBHI [(AOR: 2.7 ; 95% CI : [0,0.192)], had statistically significant association with
community-based health insurance enrolment. Conclusion: The prevalence of communitybased
health
insurance
enrolment in this study area was low. This study pinpointed the need
to disseminate information and discuss with community on the issues related to principles of
community-based health insurance, the benefit packages, the premium and efforts should be
devoted to meet expectation of the community regarding the quality of healthcare by the
District health office, insurance officials and health professionals to enhance the enrolment.
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Keywords
Community-based health insurance, enrolment, utilization, scheme, southern Ethiopia.