Abstract
BackgroundIntroduction of a health insurance scheme is one of the ways to enhance access to health care services and to protect individuals from catastrophic health expenditures. Little is known on the influence of socio-demographic and social marketing strategies on enrollment and re-enrollment in the Community Health Fund/Tiba Kwa Kadi (CHF/TIKA) in Tanzania.MethodsThis cross-sectional study employed quantitative methods for data collection between November 2014 and March 2015 in Singida and Shinyanga regions. Relationship between variables was obtained through Chi-square test and multivariate logistic regression.ResultsWe recruited 496 participants in the study. Majority (92.7%) of participants consented to participate, with 229 (49.8%) and 231 (50.2%) members and non members of CHF/TIKA respectively. Majority (90.9%) were aware of CHF/TIKA. Majority of CHF/TIKA members and non-members (90% and 68.3% respectively) reported health facility-based sensitization as the most common social marketing approach employed to market the CHF/TIKA. The most popular marketing strategies in the country including traditional dances, football games, radio, television, news papers, and mosques/church were reported by few CHF and non CHF members. Multivariate Logistic regression models revealed no significant association between social marketing strategies and enrollment, but only socio-demographics; including marital status (AOR = 2.0, 95% CI 1.1–3.8) and family size (household with ≥ 6 members) (AOR = 1.5, 95% CI 1.0–2.5), were significant factors associated with enrollment/re-enrollment rate.ConclusionsThis study indicated that low level of utilization of available social marketing strategies and socio-demographic factors are the barriers for attracting members to join the schemes. There is a need for applying various social marketing strategies and considering different facilitating and impending socio-demographic factors for the growth and sustainability of the scheme as we move towards universal health coverage.
Highlights
Introduction of a health insurance scheme is one of the ways to enhance access to health care services and to protect individuals from catastrophic health expenditures
This study aimed to identify barriers and assessed facilitators to the social marketing strategies used to enroll and re-enroll people in Community Health Fund (CHF)/Tiba kwa Kadi’ (TIKA) schemes in two regions of Tanzania
We explored the barriers to enrolling people in the schemes through the existing social marketing strategies in the study areas
Summary
Introduction of a health insurance scheme is one of the ways to enhance access to health care services and to protect individuals from catastrophic health expenditures. Introduction of a health insurance scheme is one of the ways to try the inequalities and improve access to health care services, protecting the individuals from catastrophic health payments [1]. There has been some evidence that community health insurance reduces catastrophic health care expenditures and increases access to health care services [2]. The supply side factors, such as inadequate benefit packages, poor quality of health services, failure to see rationale to insure, limited benefit package and weak management of the schemes, contributes to the low enrollment [4,5,6]. Social marketing remains to be a corner stone factor to the enrolment and re-enrolment to CHF/TIKA
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
