Assessing Factors Associated with Poor Community Based Health Insurance Client Satisfaction Level with Public Health Care Services in Negele Arsi Woreda Health Centers, West Arsi Zone Ethiopia

Objective: Community-based health insurance (CBHI) schemes are an emerging tool for providing financial protection against health-related poverty. In Ethiopia, CBHI is being piloted in 13 districts and expanded to 427 but community satisfaction with the scheme and health service delivery study have yet limited. Therefore, this study aimed to assess the satisfaction of CBHI client on the public health service they acquire. Methods: A facility based cross-sectional study design was conducted from March and April, 2019 in Arsi Nagele Woreda health centers. Three hundred ninety eight participants who visited the health care facility during the study period were included for quantitative and key informants interview were conducted.Data were entered in to and analyzed using SPSS version 22 and analyzed using descriptive and logistic regression model for quantitative and thematic analysis for qualitative study. Result: A total of 399 patients were participated in the study, yielding a response rate of 95% of which, 63.1 % were male, 24.4% of the clients were illiterates and almost 50% were from Kello Dure health center. The findings of the study showed that the overall client satisfaction level of CBHI with the health services received from the targeted health centers were 63.4% (95% CI=26.1-35.2). Clients who aged from 15-24 years [AOR=0.34 (95%CI=1.34-8.00)]. Those who have level of secondary education and above [AOR=0.45 (95% CI: 1.56-4.40)], waiting time at consultation area [AOR=0.68 (95% CI: 1.01-3.87)] and drugs availability [AOR=0.71 (95% CI: 2.15-10.30)]. Clients who were informed about service available at health facilities [AOR=2.11(95% CI: 1.29- 3.47)] were less likely unsatisfied with service delivered at health facilities. Qualitative research showed that the most unsatisfactory aspect for the CBHI clients on health service was lack of human power and Drugs. Conclusion and recommendation: This study showed higher clients’ satisfaction level in Arsi Negele district health facilities when compared to similar studies in the country. Young age, lack of drugs and supplies, poor information provision, long waiting time at consultation, was found to be the major causes of dissatisfaction. Therefore, the districthealth offices better to work on the quality of the service particularly around the waiting time of patient and health care provider interaction and drug accessibility.