Assessment of Factors Affecting Insurance in Yirgalem Town, Ethiopia Assessment of Factors Affecting Dropout of Community Based Health Insurance in Yirgalem Town, Ethiopia.
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Date
2019-07
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Addis Abeba University
Abstract
Back ground: To access quality of care and overcome catastrophic out of pocket expense nations
working on community based health insurance whereby risk pooling and sharing. To achieve this,
households enrolled in the insurance and also renewed their membership since health insurance is an
instrument in achieving universal health coverage. Even if the amount of the initial up take and
enrollment is important, high dropout rate endangers the sustainability of community based health
insurance (CBHI) and enhances the existing enrollment problems.
Objectives: To asses factors affecting dropout of community based health insurance (CBHI)
members from community based health insurance (CBHI) scheme.
Methods: Community based cross sectional study design was employed using interviewer
administered questioners and supplemented by qualitative in-depth interviewer questioners to assess
factors affecting dropout of CBHI in Yirgalem town. 3 kebeles were selected by using simple
random sampling method .And the study participants were selected by using systematic random
sampling technique. The sample size required for the study is 376.Quantitative data was entered in to
SPSS version 24 for analyses. Qualitative data was transcribed, analyzed manually using the
thematic area analysis approach.
Results: The study found that educational statuses of respondents were found to be an associated
factor for drop out of CBHI. Households who are illiterate were 1.73 times more likely to drop out
from CBHI than those who were sinor and above, AOR = 1.73, 95% CI (0.365, 0.566). Socio
economic status of households also affect dropout. Household with wealth status of low income
were 2.5 times less likely to drop out from the CBHI than those medium wealth statuses, AOR = 2.5;
95% CI (1.89, 3.40). While households with higher income group were 1.58 times more likely to
drop out than those middle income groups, AOR = 1.58; 95% CI (2.04, 4.89). Limited scope of
illness covered by the scheme is also reason and positively correlated with members to drop out from
their membership (r=0.474 at p=0.00).
Conclusion: This study brings reasons and factors for drop out of CBHI membership. It is found
that education, socio economic status, limited scope of illness, distance from health facility, quality
of health care services were correlated with dropout of CBHI.
Recommendation: Regional Health Bureau, Zonal and woreda health office should work to
improve quality of health care service, availability of drugs and functionality of laboratory
instruments.
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Keywords
Community based health insurance, dropout, universal health coverage