Clients’ Satisfaction with Community-Based Health Insurance Scheme and Associated Factors: The Case of Black Lion Specialized Hospital.
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Date
2025-10-01
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Addis Abeba Universty
Abstract
Ethiopia has been implemented CBHI scheme since 2011 for informal sectors for the purpose of financial protection, enhance healthcare and equity health services. The objectives of this study was to assess clients’ satisfaction with CBHI and associated factors in the case of BLSH. The study employed a mixed approach, cross-sectional descriptive and phenomenological design. The data were collected from 364 respondents (49.7% male and 50.3% female) using structured questionnaires for quantitative data and interviews with FGDs and IDIs for qualitative data from April 23 to May 23, 2025. Systematic and purposive data sampling techniques used to collect the quantitative and qualitative data respectively. The quantitative data were analyzed using SPSS 21 and the qualitative data were analyzed thematically. The result of this study revealed that the overall clients’ satisfaction with CBHI scheme was 57.7 % and Satisfaction of clients was significantly associated with the clients’ age between 40-50 (AOR=3.1, 95% CI: (1.35-6.8)(p<0.007), residency lived in rural areas (AOR=2.4, 95% CI(1.4-4.2)(P<0.001), monthly income from 2001-5000 birr (AOR=2.84, 95% CI:(1.45-5.58)(P<0.002) and knowledge on cosmetic surgery (AOR=0.02,95% CI:(0.003-0.0098)(P<0.000) were more satisfied than the counter parts. On clients experience, factors associated with clients’ satisfaction were clients with some health problems (AOR=3.52, 95% CI: (1.92-6.46) (P<0.000), clients registered before their illness (AOR= 1.84, 95% CI: (1.06-3.12) (P<0.029), clients say CBHI enrollment and renewal period were comfortable (AOR=2.77, 95% CI: (1.56-4.92) (P<0.001) and clients voluntarily enrollment for CBHI (AOR=0.278, 95% CI: (0.13-0.58) (P<0.001).The study also revealed that clients were challenged by a shortage of medications and pharmaceutical supplies, inadequate services in the laboratory and imaging, insufficient hospital facilities, difficult setup of the hospital, and indirect costs. Clients were satisfied with health providers’ services and unsatisfied with the hospital’s healthcare service provision. The overall satisfaction of clients with CBHI was suboptimal concerning both health providers and hospital services. The study gave insight for different actors, such as the hospital itself, policy makers, social workers and researchers, to identify the gaps and improve the service provision related to prescribing drugs, laboratory services, imaging services and fulfilling the hospital infrastructures for clients’ quality services and satisfactory healthcare services.
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Health insurance Community-Based Health Insurance level of Satisfaction