Abstract
Back ground : CBHI is a kind of insurance for informal sectors through which the members contribute some amount of money to protect themselves against the high costs of seeking medical care and treatment for illness. The catastrophic nature of health care financing mechanism for the poor and often rural population has been a source of concern in the low and middle income countries . The aim of this study was to assess the household's willingness to join CBHI and factors affecting households to join community based health insurance. . Methodology : A community based cross sectional study was conducted in randomly selected districts of West Shoa Zone from January 25 to February 20, 2016. A sample of 292 head of the house holds were selected using simple random sampling technique from which data were collected by trained data collectors using a pre-tested structured questionnaire. The collected data were entered into SPSS version 20 for analysis .Descriptive statistics and bivariate and multiple logistic regression analyses were performed. Result: All of the 292 sampled head of the households participated in the study making the response rate of 100 %. About 71% of the respondents were willing to join the scheme. In multivariate logistic regression analyses, age of the head of the house holds , head of the household, the household's family size and having a person age 65 and above in the family, presence of chronic illness among the house holds , households concern for covering the health care cost and means of getting money for health care payment were found to be the predictors of the households' WTJ the CBHIs . Conclusion: In the study the households willingness to join community based health insurance was considered to be high. Therefore, scaling the scheme will be beneficial in the study areas. Keywords: Community based health insurance, Willingness to join, West Shoa Zone, Ethiopia DOI : 10.7176/JHMN/65-03 Publication date : August 31 st 2019
Highlights
Back ground Community based health insurance is the kind of insurance for informal sectors through which members contribute some amount of money to protect themselves against the high cost of seeking medical care and treatment for illness [1,2]
Operating by risk-pooling, they are financed through regular premiums and tailored to meet the needs of poorer people such as informal sector workers who would otherwise not be able to take out health insurance [5, 6]
Since the mid-90s, CBHI schemes have been growing in number in Sub-Saharan Africa and other regions of the world [13].,The number of Community based health insurance schemes grew from 76 in 1997 to more than 800 by 2004 [14], and it is part of the national health financing strategy in Benin, Ghana, Rwanda, Senegal and Tanzania [15,16,17]
Summary
Back ground Community based health insurance is the kind of insurance for informal sectors through which members contribute some amount of money to protect themselves against the high cost of seeking medical care and treatment for illness [1,2]. In sub- Saharan African out of pocket expenditure constitutes approximately 40% of the total health expenditure, imposing financial burdens and limiting access to health care [19, 20] Since such direct out –of- pocket payments are inequitable and inefficient in financing healthcare services [21], in the late 1990s there was a move away from out- of- pocket expenditure on health care to community based health insurance in most developing countries[22]. In response to adverse effects of direct out-of-pocket payments, the World Health Organization (WHO) is encouraging countries to move towards universal health coverage (UHC) This means that everyone should have access to needed healthcare services that are effective and of acceptable quality, and no one should risk financial ruin as a result of this. This is corroborated by evidence from many LMICs showing that health sector reforms in the form of adequate insurance or prepayment schemes contribute to increasing financial protection [21, 25]
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