Determinants of enrollment in community based health insurance program among households in East Wollega Zone, west Ethiopia: Unmatched case-control study.

IF 1.6 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Journal of Public Health Research Pub Date : 2023-07-01 DOI:10.1177/22799036231187101

Mengistu Desalegn, Teferi Lemu, Bekuma Tadesse, Tariku Olana, Zalalem Kaba, Tadesse Tolossa

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Abstract

Background: Ethiopia has launched a community-based health insurance (CBHI) since 2011, which is an innovative financing mechanism to enhance domestic resource mobilization and sustainable health financing. This study assessed determinants of CBHI enrollment among HHs (households) of East Wollega, Ethiopia, 2022.

Method and materials: Community based unmatched 1:2 case-control study design was conducted between Jan 7and Feb 5/2022 among 428 HHs (144 cases and 284 controls). Cases were selected from HHs who registered for CBHI and currently using CBHI. Controls were from those who do not registered for CBHI membership. Data collected using a semi-structured, interview administered questionnaire. Multivariable logistic regression with SPSS version 25 was employed for analysis and variables were declared statistical significant association at p-value < 0.05, 95% CI.

Result: Data from 428 (144 cases and 284 controls to CBHI) were collected; a response rate of 98.8%. Statistically lower odds of CBHI enrollment was observed among HHs who have poor knowledge [AOR = 0.48 (95% CI:0.27, 0.85)], perceived not respectful care [AOR = 0.44 (95% CI :0.24, 0.81)], unavailability of laboratory services [AOR = 0.37(95% CI:0.21, 0.66)], inappropriate time of premium payment [AOR = 0.31(95% CI:0.18, 0.52)]. In addition, medium wealth status category [AOR = 0.11(95% CI: 0.03, 0.45)]. Higher odd of CBHI enrollment observed among who have formal education [AOR = 2.39(95% CI: 1.28, 4.48)].

Conclusion and recommendation: Educational level, knowledge, time of membership payment, laboratory test availability, perception of respectful care and wealth status were significant determinants of CBHI enrollment status. Hence, the responsible bodies should discuss and decide with community on the appropriate time of premium payment collection, and enhance community education on CBHI benefit package.

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埃塞俄比亚西部东沃勒加地区家庭参加社区医疗保险计划的决定因素:不匹配病例对照研究

背景:自2011年以来，埃塞俄比亚启动了以社区为基础的健康保险，这是一种创新的筹资机制，旨在加强国内资源调动和可持续的卫生筹资。本研究评估了2022年埃塞俄比亚东沃勒加(East Wollega)卫生保健工作者(家庭)中CBHI登记的决定因素。方法与材料:在2022年1月7日至2月5日期间，对428名HHs(144例病例和284例对照)进行基于社区的非匹配1:2病例对照研究设计。病例选自已登记并正在使用儿童健康保险的卫生保健工作者。对照来自未注册CBHI会员的人员。数据收集使用半结构化，访谈管理问卷。结果:共收集428例(144例，对照组284例)数据;应答率为98.8%。从统计学上看，知识差[AOR = 0.48 (95% CI:0.27, 0.85)]、感觉不尊重护理[AOR = 0.44 (95% CI: 0.24, 0.81)]、无法获得实验室服务[AOR = 0.37(95% CI:0.21, 0.66)]、支付保费时间不合适[AOR = 0.31(95% CI:0.18, 0.52)]的卫生保健人员加入CBHI的几率较低。此外，中等财富状态类别[AOR = 0.11(95% CI: 0.03, 0.45)]。在接受过正规教育的人群中，cbi入组率较高[AOR = 2.39(95% CI: 1.28, 4.48)]。结论与建议:受教育程度、知识水平、入会时间、实验室检测可及性、尊重关怀感知和财富状况是cbi入组状况的显著决定因素。因此，责任机构应与社区讨论和决定适当的保费收取时间，并加强社区对CBHI福利计划的教育。

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来源期刊

Journal of Public Health Research PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH-

CiteScore

3.70

自引率

4.30%

发文量

116

审稿时长

10 weeks

期刊介绍： The Journal of Public Health Research (JPHR) is an online Open Access, peer-reviewed journal in the field of public health science. The aim of the journal is to stimulate debate and dissemination of knowledge in the public health field in order to improve efficacy, effectiveness and efficiency of public health interventions to improve health outcomes of populations. This aim can only be achieved by adopting a global and multidisciplinary approach. The Journal of Public Health Research publishes contributions from both the “traditional'' disciplines of public health, including hygiene, epidemiology, health education, environmental health, occupational health, health policy, hospital management, health economics, law and ethics as well as from the area of new health care fields including social science, communication science, eHealth and mHealth philosophy, health technology assessment, genetics research implications, population-mental health, gender and disparity issues, global and migration-related themes. In support of this approach, JPHR strongly encourages the use of real multidisciplinary approaches and analyses in the manuscripts submitted to the journal. In addition to Original research, Systematic Review, Meta-analysis, Meta-synthesis and Perspectives and Debate articles, JPHR publishes newsworthy Brief Reports, Letters and Study Protocols related to public health and public health management activities.