Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia

Temesgen Jaleta Dibaba; Dufera Rikitu Terefa; Biniam Worku Hailu

doi:doi:10.11648/j.hep.20210604.12

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Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia

Temesgen Jaleta Dibaba, Dufera Rikitu Terefa, Biniam Worku Hailu

Published in International Journal of Health Economics and Policy (Volume 6, Issue 4)

Received: 30 November 2021 Accepted: 20 December 2021 Published: 29 December 2021

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Abstract

Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value <0.05 and AOR values with 95% CI. Finally, fitness of the model was checked by using Hosmer and Lemeshow goodness-of-fit test. Results: Of the sampled respondents, 543 participated in this study with response rate of 98.3%. Of these, 426 (78.5%) were willing to join the scheme. The study found that, educational status of who can read and write [AOR=3.96; 95% CI, 2.02, 7.75], family size > 5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.

Published in	International Journal of Health Economics and Policy (Volume 6, Issue 4)
DOI	10.11648/j.hep.20210604.12
Page(s)	118-126
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Community Based Health Insurance, Willingness to Join, Ethiopia

References

[1]	World Health Organization. WHO Global Health Expenditure Atlas. © World Health Organization 2014 who Geneva: 2014 Geneva WHO. 2014; Available from: http://www.who.int/about/licensing/copyright_form/en/index.html.
[2]	Federal Democratic Republic of Ethiopia Ministry of Health: Ethiopia’s fifth national health accounts highlight of major findings. Addis Ababa, Ethiopia: Ministry of Health Ethiopia. 2014; (April).
[3]	World health organization. The World Health Report. Health System Financing. The path to universal coverage. [Internet]. Geneva: 2010; Available from: http://www.who.int/whr/ 2010/en/index.html.
[4]	World Health Organization. Health systems financing. Geneva: World Health Organization; 2010; 71–84.
[5]	Federal Democratic Republic of Ethiopia Ministry of Health: Ethiopia’s Community-based Health Insurance: A Step on the Road to Universal Health Coverage. Addis Ababa, Ethiopia: Ministry of Health Ethiopia. 2011.
[6]	Federal Democratic Republic of Ethiopia Ministry of Health: Health Care Financing Reform in Ethiopia: Improving Quality and Equity. Addis Ababa, Ethiopia: Ministry of Health Ethiopia. 2020.
[7]	Shimeles A, Woldemichael A, Gurara DZ. Community-Based Health Insurance and Out-of-Pocket Healthcare Spending in Africa: Evidence from Rwanda. 2016; (9922).
[8]	Getachew M, Sinkie SO, Handalo DM, Salgedo WB, Kehali KY, Kebene FG, et al. Willingness to Join and Pay for Community-Based Health Insurance Among Rural Households of Selected Districts of Jimma Zone, Southwest Ethiopia. Dove Press Journal of ClinicoEconomics and Outcomes Research. 2020: 122020; 12: 45–55.
[9]	Ijeoma A, Adebayo O, Babatunde O, Angela E. Community based health insurance as a viable option for health financing: An assessment of household willingness to pay in Lagos, Nigeria. Journal of Public Health and Epidemiology. 2019; 11 (2 (February)): 49–57.
[10]	Zone EWZ. East wollega Zonal Health department. Annual report.(Unpublished). 2020.
[11]	Haile M, Ololo S, Megersa B. Willingness to join community-based health insurance among rural households of Debub Bench. BMC Public Health. 2014; 14 (591): 1–10.
[12]	Kibret GD, Leshargie CT, Wagnew F, Alebel A. Willingness to join community based health insurance and its determinants in East Gojjam zone, Northwest Ethiopia. BMC Res Notes [Internet]. 2019; 1 (1): 3–8. Available from: https://doi.org/10.1186/s13104-019-4060-3.
[13]	Kebede A, Gebreslassie M, Yitayal M. Willingness to pay for community based health insurance among households in the rural community of Fogera. Science PG International Journal of Economics, Finance and Management Sciences. 2014; 2 (4): 263–9.
[14]	Adedeji A, Doyin A, Kayode O, Ayodele A. Knowledge, Practice and Willingness to Participate in Community Health Insurance Scheme among Households in Nigerian Capital City. Sudan J Med Sci. 2017; 12 (1): 9–18.
[15]	Demeke GB. Willingness to Join Community-Based Health Insurance and Its Associated Factors among Households in West Gojjam Zone, North Mecha. 2021. Available from: DOI: https://doi.org/10.21203/rs.3.rs-952468/v1License.
[16]	Tibebu NS. Willingness to Enroll for Community-Based Health Insurance and Associated Factors in Simada District, North-West, Ethiopia, 2020: A Community-Based Cross-Sectional Study. Dove Press Journal of Risk Management and Healthcare Policy 2020: 132020.
[17]	Wafo R, Tchabo W, Tchamy J. Heliyon Willingness to join and pay for community-based health insurance and associated determinants among urban households of Cameroon: case of Douala and Yaounde. Heliyon [Internet].2021; 7 (January): e06507. Available from: https://doi.org/10.1016/j.heliyon.2021.e06507.
[18]	Ebrahim K, Yonas F, Kaso M. Willingness of community to enroll in community based health insurance and associated factors at household Level in Siraro District, West Arsi Zone, Ethiopia. Journal of Public Health and Epidemiology. 2019; 11 (August): 137–44.
[19]	Mirach TH, Demissie GD, Biks GA. Determinants of community-based health insurance implementation in west Gojjam zone, Northwest Ethiopia: a community based cross sectional study design. BMC Health Services Research. 2019; 1–8. Available from: https://doi.org/10.1186/s12913-019-4363-z.
[20]	Zone BM, Haile M, Ololo S, Megersa B. Willingness to join community-based health insurance among rural households of Debub Bench. BMC Public Health. 2014; 1–10. Available from: http://www.biomedcentral.com/1471-2458/14/591.
[21]	Taddesse G, Atnafu DD, Ketemaw A, Alemu Y. Determinants of enrollment decision in the community-based health insurance, North West Ethiopia: a case-control study. Globalization and Health. 2020; 16 (4): 1–9. Available from: https://doi.org/10.1186/s12992-019-0535-1.
[22]	Belete M, Id F, Roba KT, Merga BT, Tefera BN. Factors associated with enrollment for community-based health insurance scheme in Western Ethiopia: Case-control study. 2021; 1–10. Available from: http://dx.doi.org/10.1371/journal.pone.0252303.

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APA Style

Temesgen Jaleta Dibaba, Dufera Rikitu Terefa, Biniam Worku Hailu. (2021). Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. International Journal of Health Economics and Policy, 6(4), 118-126. https://doi.org/10.11648/j.hep.20210604.12

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ACS Style

Temesgen Jaleta Dibaba; Dufera Rikitu Terefa; Biniam Worku Hailu. Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. Int. J. Health Econ. Policy 2021, 6(4), 118-126. doi: 10.11648/j.hep.20210604.12

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AMA Style

Temesgen Jaleta Dibaba, Dufera Rikitu Terefa, Biniam Worku Hailu. Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. Int J Health Econ Policy. 2021;6(4):118-126. doi: 10.11648/j.hep.20210604.12

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@article{10.11648/j.hep.20210604.12,
  author = {Temesgen Jaleta Dibaba and Dufera Rikitu Terefa and Biniam Worku Hailu},
  title = {Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia},
  journal = {International Journal of Health Economics and Policy},
  volume = {6},
  number = {4},
  pages = {118-126},
  doi = {10.11648/j.hep.20210604.12},
  url = {https://doi.org/10.11648/j.hep.20210604.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20210604.12},
  abstract = {Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value  5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.},
 year = {2021}
}

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TY  - JOUR
T1  - Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia
AU  - Temesgen Jaleta Dibaba
AU  - Dufera Rikitu Terefa
AU  - Biniam Worku Hailu
Y1  - 2021/12/29
PY  - 2021
N1  - https://doi.org/10.11648/j.hep.20210604.12
DO  - 10.11648/j.hep.20210604.12
T2  - International Journal of Health Economics and Policy
JF  - International Journal of Health Economics and Policy
JO  - International Journal of Health Economics and Policy
SP  - 118
EP  - 126
PB  - Science Publishing Group
SN  - 2578-9309
UR  - https://doi.org/10.11648/j.hep.20210604.12
AB  - Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value  5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.
VL  - 6
IS  - 4
ER  -

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Author Information

Temesgen Jaleta Dibaba

Community Based Health Insurance Scheme, Buno Bedele Zonal Health Department, Bedele, Ethiopia
Dufera Rikitu Terefa

Departments of Public Health, Institute of Health Science, Wollega University, Nekemte, Ethiopia
Biniam Worku Hailu

Human Resource Developments and Management Directorate, Oromia Regional Health Bureau, Addis Ababa, Ethiopia

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APA Style

Temesgen Jaleta Dibaba, Dufera Rikitu Terefa, Biniam Worku Hailu. (2021). Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. International Journal of Health Economics and Policy, 6(4), 118-126. https://doi.org/10.11648/j.hep.20210604.12

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ACS Style

Temesgen Jaleta Dibaba; Dufera Rikitu Terefa; Biniam Worku Hailu. Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. Int. J. Health Econ. Policy 2021, 6(4), 118-126. doi: 10.11648/j.hep.20210604.12

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AMA Style

Temesgen Jaleta Dibaba, Dufera Rikitu Terefa, Biniam Worku Hailu. Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia. Int J Health Econ Policy. 2021;6(4):118-126. doi: 10.11648/j.hep.20210604.12

Copy | Download

@article{10.11648/j.hep.20210604.12,
  author = {Temesgen Jaleta Dibaba and Dufera Rikitu Terefa and Biniam Worku Hailu},
  title = {Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia},
  journal = {International Journal of Health Economics and Policy},
  volume = {6},
  number = {4},
  pages = {118-126},
  doi = {10.11648/j.hep.20210604.12},
  url = {https://doi.org/10.11648/j.hep.20210604.12},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20210604.12},
  abstract = {Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value  5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.},
 year = {2021}
}

Copy | Download

TY  - JOUR
T1  - Willingness to Join Community Based Health Insurance and Its Predictors Among Informal Sectors in Buno Bedele Zone, South West Ethiopia
AU  - Temesgen Jaleta Dibaba
AU  - Dufera Rikitu Terefa
AU  - Biniam Worku Hailu
Y1  - 2021/12/29
PY  - 2021
N1  - https://doi.org/10.11648/j.hep.20210604.12
DO  - 10.11648/j.hep.20210604.12
T2  - International Journal of Health Economics and Policy
JF  - International Journal of Health Economics and Policy
JO  - International Journal of Health Economics and Policy
SP  - 118
EP  - 126
PB  - Science Publishing Group
SN  - 2578-9309
UR  - https://doi.org/10.11648/j.hep.20210604.12
AB  - Background: Financial risk protection is one of the pillars of universal health coverage. Community based health insurance (CBHI) scheme is the risk sharing mechanism to reduce large out-of-pocket payments for health care and to overcome financial barriers to access health care. However, evidence on the level of willingness to join community based health insurance in the study area was scanty. Objective: This study aimed to assess willingness to join community based health insurance scheme and its predictors among informal Sectors in Buno Bedele zone, Southwest Ethiopia, 2021. Methods: A community-based cross-sectional study design was conducted on willingness to join community based health insurance and its predictors among informal sectors in Buno Bedele Zone, South west Ethiopia from January 01 to 30, 2021. Multistage simple random sampling was used to select 555 households. Data were collected using a semi-structured interviewer-administered pretested questionnaire. Data were entered into Epi-Data version 3.1 and analyzed with SPSS Version 25. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value  5 [AOR=2.61; 95% CI, 1.45, 4.17], poor households [AOR=4.89; 95% CI, 2.79, 8.57], experience of an illnesses in the last three months [AOR=2.28; 95% CI, 1.21, 4.30], had information about CBHI [AOR=2.24; 95% CI, 1.18, 4.25] and participating in any indigenous community insurance [AOR=7.86; 95% CI, 4.47, 3.83] were significant predictors of willingness to join the scheme. Conclusion: The study revealed that more than three fourth of respondents were willing to join CBHI. Educational status of who can read and write, family size > 5, poor households, experience of an illnesses, had information about CBHI and participating in any indigenous community insurance were more likely to join the scheme. So, the government should strengthen efforts to scale up this scheme in the informal sectors specifically to areas not yet implemented, to reduce direct out-of-pocket payment at service delivery points. This will contribute to guarantee informal sectors access to quality health services without facing financial hardship, to achieve universal health coverage for all.
VL  - 6
IS  - 4
ER  -

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