Abstract
BackgroundCommunity-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty. In Ethiopia, CBHI is being piloted in 13 districts, but community experience and satisfaction with the scheme have yet to be studied. Therefore, this study aimed to assess the experiences and satisfaction of households enrolled in a pilot CBHI scheme.MethodsA community-based cross-sectional study method was used in one pilot district in South Ethiopia. Data were collected in March and April 2014. 386 households enrolled in the CBHI scheme were sampled by simple random sampling. Data were collected by trained data collectors using a pre-tested structured questionnaire. Descriptive statistics and bivariate and multiple linear regression analyses were performed. P values less than 0.05 and 95 % confidence intervals were used to determine associations between independent and dependent variables.ResultsThe study revealed that overall household satisfaction with CBHI was 91.38 %. Moreover, there was a significant association between health service provision and CBHI members’ satisfaction scores. For instance, household heads that strongly disagreed with laboratory services provision had an average 0.878 decrease in CBHI satisfaction score compared to household heads that strongly agreed. CBHI process- and management-related factors were also significantly associated with satisfaction.ConclusionsSatisfaction with CBHI was high. Age, family size, laboratory services provision, health services provider friendliness, CBHI offices opening times, membership card collection process, and time interval to use of services were significant predictors of satisfaction with CBHI.
Highlights
Community-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty
The card collection process, CBHI office opening times, time interval to use benefits, and paying the premium were all significantly associated with member satisfaction (Table 5)
This might be attributed to more frequent illness in elderly people. Other variables such as occupation, education, marital status, sex, and income were not significant predictors, consistent with studies conducted in India on national health insurance satisfaction, who found no differences in satisfaction across socioeconomic and demographic variables [3]
Summary
Community-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty. In Ethiopia, CBHI is being piloted in 13 districts, but community experience and satisfaction with the scheme have yet to be studied. This study aimed to assess the experiences and satisfaction of households enrolled in a pilot CBHI scheme. Millions of people in developing countries still suffer and die from health-related conditions for which effective but underutilized interventions exist, in settings that lack effective health insurance policies [5]. Most developed countries use tax-based systems, social health insurance systems, or mixed systems to achieve universal coverage [10]. Community-based health insurance (CBHI) schemes are an emerging and growing tool for providing financial protection to deprived individuals against
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