Client’s Satisfaction with a Community Based Health Insurance Scheme and Associated Factors in Addis Ababa.
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Date
2021-06
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Addis Abeba University
Abstract
Many countries introduced CBHI as their health care financing system to ensure healthcare
access. Understanding the level of satisfaction and factors associated with the level of
satisfaction in Addis Ababa is essential to ensure the sustainability of the program. Therefore,
this study assessed the level of satisfaction of CBHI members and its associated factors.
Methodology: Institutional based cross- sectional study was conducted on a sample of 419
beneficiaries in the ten health centers found in the ten sub cities of Addis Ababa, which have deal
with their respective scheme to give service to members. Both quantitative and qualitative
methods were used. Data was collected using pretested structured questionnaire and FGD
guide. Descriptive and binary logistic regression analysis was carried out to identify its
associated factors. Odds ratio with 95% confidence interval was calculated using logistic
regression analysis. Finally, variables with p-value of <0.05 has been considered as statistically
significant. Data from the qualitative part was analyzed by using thematic analysis
Result: In this study, the overall satisfaction level of households with the community-based
health insurance was found to be 46.3%. Satisfaction of CBHI members was positively
associated with CBHI management regulations (AOR= 1.96, 95% CI: 1.12, 3.46). In addition
participants who received the right drug (AOR=1.77, 95% CI: 1.08, 2.93), households who got
immediate care during the recent visit (AOR = 4.95, 95% CI: 2.72, 8.98), those who agreed with
the adequacy of medical equipment at the permitted public health institutions (AOR = 1.65, 95%
CI: 1.02, 2.69), and households who agreed on the adequacy and qualification of health
personnel (AOR= 1.89, 95% CI: 1.12, 3.20) were more satisfied with the scheme than their
counter parts. The challenges mentioned by the discussants were shortage of drugs, disrespect
and poor attitude of health professionals, absence of kenema pharmacy in their nearby place,
lack of laboratory and other diagnostic service, health professionals lacked awareness about
CBHI scheme, and rigid premium payment modality.
Conclusion and Recommendation: In this study, the satisfaction level of members of CBHI
scheme was found to be low. In order to achieve a better result and ensure the sustainability of
CBHI program the health bureau together with sub cities should do further investigations on the
qualification and competency of health professionals, availability of medication and medical
equipment and attitude of pharmacists at Kenema pharmacies towards CBHI members.
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Keywords
Community , health insurance