Community Based Health Insurance Scheme as a New Healthcare Financing Approach in Rural Ethiopia: Role on Access, Use and Quality of Healthcare Services, the Case of Tehuledere District, South Wollo Zone, Northeast Ethiopia

Abstract

Community based health insurance scheme is an emerging and promising concept to access affordable and effective healthcare, to protect households from out of pocket expenditure and impoverishment. Accordingly, this study examined access, use and quality of services after the introduction of the scheme in Ethiopia. To conduct this study, mixed research approach, descriptive, inferential and thematic analysis employed concurrently to collect data from participants. The study finding disclosed that by avoiding out of pocket payment, community based health insurance improve access and overall quality of service. Moreover, health services utilization improved from 0.33 visits of individual per year in 2011 to 1.44 visits in 2016. However, there were limitations in some quality indicator, moral hazards (miss utilizations) and adverse selections (inclusion of chronically ill, poor and indigents) during enrolment. Generally, the purpose of the scheme is threefold: increase access and use by making healthcare services more affordable and equitable, improve health status of population, and mitigate the out of pocket financial consequences of ill health by distributing the costs of healthcare across all members of a risk pool within the scheme.