Enrollment of Households in Community-Based Health Insurance (CBHI) in Ethiopia: The Case of the Aleltu District

Gutama Namomsa Daraje
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Abstract

In developing countries, people’s attitude about their health is very poor. People visit health institutions only when they are sick. This trend is especially common in rural areas. For the majority of people, health care is accessed and covered by money sourced from their existing funds or assets, which frequently results in citizens not using health care services. Poor health care financing remains a major challenge for the health system in Ethiopia. It leaves households vulnerable to impoverishment from high health expenditures and slows progress towards health improvements such as the Sustainable Development Goals, limiting access to essential health services among citizens with lower socio-economic status. Important barriers to improved health care financing include low government spending on the health sector, strong reliance on out-of-pocket expenditure, inefficient and inequitable utilization of resources, and poorly harmonized and unpredictable donor funding. Different studies illustrated that in developing countries the majority of people from poor families cover health care costs with out-of-pocket funding. As a result, many fall into debt, which aggravates the severe poverty conditions. This study revealed that all households (n=150) are aware. This awareness has positive contribution on enrollment and sustainability of the scheme by minimizing the drop out of the member. The major benefit the households experienced by enrolling in Community-Based Health Insurance (CBHI) is that it saves people from having unplanned health costs. Eighty percent of the respondents stated that their health status improved and that their families were insured. Currently, both premiums were paid and Poor members of the scheme are enrolling in the Aleltu district because they understand the advantages of being members of CBHI.
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埃塞俄比亚社区医疗保险家庭登记:以阿勒图县为例
在发展中国家,人们对健康的态度很差。人们只有在生病时才去卫生机构。这一趋势在农村地区尤为普遍。对于大多数人来说,获得和支付医疗保健的资金来自他们现有的资金或资产,这往往导致公民不使用医疗保健服务。卫生保健筹资不足仍然是埃塞俄比亚卫生系统面临的主要挑战。它使家庭容易因高额卫生支出而陷入贫困,并减缓了实现可持续发展目标等改善健康方面的进展,限制了社会经济地位较低的公民获得基本卫生服务的机会。改善卫生保健筹资的重要障碍包括:政府在卫生部门的支出低、严重依赖自付支出、资源利用效率低下和不公平,以及捐助者供资不协调和不可预测。不同的研究表明,在发展中国家,大多数来自贫困家庭的人用自付资金支付保健费用。结果,许多人负债累累,使严重的贫困状况更加恶化。该研究显示,所有家庭(n=150)都意识到了这一点。这种意识通过最小化成员的退出,对计划的注册和可持续性做出了积极贡献。家庭参加社区医疗保险的主要好处是,它使人们免于支付计划外的医疗费用。80%的答复者说,他们的健康状况有所改善,他们的家庭有保险。目前,该计划的贫困成员都支付了保费,并在Aleltu地区注册,因为他们了解成为CBHI成员的优势。
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