Comparing healthcare service utilization in insured vs. noninsured households in Rural Atsbi Womberta, Ethiopia

Abstract

Community-based health insurance schemes (CBHI) in Africa are gaining attention due to high healthcare costs in developing nations, affecting 6% of individuals in extreme poverty. The World Health Organization emphasizes the need for sustainable health funding schemes to ensure access to health services. Ethiopia faces poor healthcare funding, making it one of the world's poorest nations. Tigray implemented community-based insurance as a pilot study in 69 rural communities since 2010. The objective of this study was compare differences in healthcare service utilization between community-based health insurance among insured and non-insured households in rural Atsbi-Wemberta district. A community-based comparative cross-sectional study with a qualitative approach was conducted on 172 households. Data was analyzed using SPSS, and inferential statistics were used to measure factors' association with outcome variables. A study in Kebelle revealed that the majority of respondents were female-headed, engaged in both insurance schemes, and had higher education levels. Marital status was also significant, with 89% living with their families. The majority were married, with 91.8% insured and 86.0% uninsured. Family size and income were significant factors, with high-salary households less likely to be members of the CBHI scheme. The study found that most participants considered themselves intermediate healthcare providers, with limited service due to affordability and segregation. The study suggests increasing healthcare service utilization by introducing CBHI to improve access to healthcare and promote good governance. However, the study faces criticism for unfairness and insufficient benefits for non-insured participants. Household were enrolled in CBHI (56.2%) were more probable to use health care service than households who were not enrolled (43.8%) (χ2=21.359, p<0.001). Community Benefits Insurance (CBHI) has increased healthcare utilization among insured households due to reduced illness costs and increased healthcare professional involvement. Factors like income, family size, and travel time contribute to higher utilization. However, challenges include lack of knowledge and community awareness.