Abstract
Health insurance is a viable strategy to facilitate accessibility of health care but it favors the formal sector workers while leaving behind the informal sector workers who are the majority. This mixed methods study involved 889 informal sector workers from Dar es Salaam, Tanzania. Income, membership to economic groups, education, age, insurance regulations, fragmentation of insurance providers, cultural beliefs and low priority on health insurance were significantly associated with uptake of health insurance. Low uptake of health insurance increases inaccessibility of health care. Subsidizing the premium and using innovative strategies to increase understanding will improve health service accessibility.
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