scholarly journals Determinants of willingness to participate in community-based health insurance among People Living with HIV in South-East Nigeria

2020 ◽  
Vol 101 ◽  
pp. 215
Author(s):  
C. Alo ◽  
I. Okedo-Alex ◽  
I. Akamike
Keyword(s):  
Health Insurance ◽  
People Living With Hiv ◽  
Willingness To Participate ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Living With Hiv

scholarly journals COMMUNITY-BASED HEALTH INSURANCE SCHEME IN A RURAL COMMUNITY OF NORTH WEST NIGERIA: A ROADMAP TO ACHIEVING UNIVERSAL HEALTH COVERAGE.

2020 ◽  
Vol 14 (2) ◽  
pp. 125-130
Author(s):  
Lawal A ◽  
◽  
Gobir AA ◽  
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Health Care Services ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Insurance Scheme ◽  
Community Based ◽  
Quality Health Care ◽  
Community Based Health Insurance ◽  
Care Services

Background: Community Based Health Insurance (CBHI) scheme is aimed at reducing out of pocket spending on health care services, ensuring final risk protection to all, especially the poor and the most vulnerable, improvement of quality of health care services, access and utilization as well as the promotion of equity. Objective: This research was aimed at determining willingness to participate in a community-based health insurance scheme among rural households in Katsina State. Method: A cross-sectional descriptive study was conducted in December 2016 among households of Batagarawa LGA, Katsina State. We used a pre-tested, electronic, semi-structured interviewer-administered questionnaire to obtain data from households that were selected using a multistage sampling technique and we analyzed the data using STATA version 13. Results: Most, (28.5%) of the respondents were in the age range of 30-39 years with a mean age of 35.5 years. Males were the dominant household heads (93%). Most were married (90%). Most, (90.5%) of households were willing to pay for a community-based health insurance scheme with a median premium of 100 Naira per household member per month. Conclusions: The high proportion of households willing to pay for the scheme should inform the decision of policy makers to design and maintain Community Based Health Insurance Scheme to improve access to and utilization of quality health care services.

scholarly journals Willingness to Participate and Pay into a Community- Based Health Insurance Scheme in Imesi-Ile, a Rural Community in Osun State, Nigeria

2020 ◽  
pp. 73-84
Author(s):  
Oluwaseun T. Esan ◽  
Ridwan O. Opeloye ◽  
Taiwo W. Oyeniyi ◽  
Ayodele O. Joseph ◽  
Ifeoluwa B. Oluwalana ◽  
...  
Keyword(s):  
Health Insurance ◽  
Rural Community ◽  
Contingent Valuation Method ◽  
Statistical Significance ◽  
Health Insurance Scheme ◽  
Willingness To Participate ◽  
Insurance Scheme ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Household Heads

Aims: Rural dwellers are forced into a vicious circle of lack of financial risk protection to accessing non-optimal care and more poverty from its complications because out-of-pocket payment is their mainstay health care financing option. A sustainable and effective Community-based health insurance scheme will offer some respite. The study aimed to determine household heads’ willingness to participate and pay into a community-based health insurance scheme and the associated factors. Study Design: Descriptive cross-sectional. Place and Duration of Study: Imesi-Ile, a rural community in Obokun Local government area of Osun state, Nigeria between July and September, 2015. Methods: Study population were 147 of the 155 household heads selected via a multi-stage sampling technique. Quantitative data collection was done using a structured questionnaire. The household health status, level of trust and reciprocity in the community, their awareness of a community-based health insurance scheme and their willingness to participate and pay into it using the double contingent valuation method were assessed. Data was analysed using the IBM SPSS version 20 software and statistical significance determined at p<0.05. Results: There was a low level of awareness (13.6%), but majority (87.1%) were willing to participate after being informed. Only 54(42.2%) were willing to pay ₦12,000 ($33.3). The maximum amount they were willing to pay was ₦6000 ($16.7). Younger household heads (p=0.009), males (p=0.032), earning ≥₦6000 ($16.7) monthly (p=0.006), and involved in cooperative schemes (p=0.002) were significantly more willing to participate in the scheme. While the sex of the household heads (p=0.006) and mean score on reciprocity (p=0.002) were significantly associated with paying ₦12,000 ($33.3) as premium for a household of 6 persons. The preferred frequency of payment was monthly (53.8%).  Conclusion: The household heads in Imesi-Ile community were willing to participate and pay into the scheme. However, further studies on the feasibility and sustainability of implementation is advised.

scholarly journals The failure of community-based health insurance schemes in Tanzania: opening the black box of the implementation process

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ramadhani Kigume ◽  
Stephen Maluka
Keyword(s):  
Health Insurance ◽  
Community Health ◽  
Rural Areas ◽  
Health Coverage ◽  
Access To Health Services ◽  
Community Based ◽  
Community Based Health Insurance ◽  
Urban Districts ◽  
Health Fund ◽  
The Government

Abstract Background Globally, there is increased advocacy for community-based health insurance (CBHI) schemes. Like other low and middle-income countries (LMICs), Tanzania officially established the Community Health Fund (CHF) in 2001 for rural areas; and Tiba Kwa Kadi (TIKA) for urban population since 2009. This study investigated the implementation of TIKA scheme in urban districts of Tanzania. Methods A descriptive qualitative case study was conducted in four urban districts in Tanzania in 2019. Data were collected using semi-structured interviews, focus group discussions and review of documents. A thematic approach was used to analyse the data. Results While TIKA scheme was important in increasing access to health services for the poor and other disadvantaged groups, it faced many challenges which hindered its performance. The challenges included frequent stock-out of drugs and medical supplies, which frustrated TIKA members and hence contributed to non-renewal of membership. In addition, the scheme was affected by poor collections and management of the revenue collected from TIKA members, limited benefit packages and low awareness of the community. Conclusions Similar to rural-based Community Health Fund, the TIKA scheme faced structural and operational challenges which subsequently resulted into low uptake of the schemes. In order to achieve universal health coverage, the government should consider integrating or merging Community-Based Health Insurance schemes into a single national pool with decentralised arms to win national support while also maintaining local accountability.

scholarly journals Community-based model for the delivery of antiretroviral therapy in Cambodia: a quasi-experimental study protocol

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sovannary Tuot ◽  
Alvin Kuo Jing Teo ◽  
Kiesha Prem ◽  
Pheak Chhoun ◽  
Chamroen Pall ◽  
...  
Keyword(s):  
Experimental Study ◽  
Antiretroviral Therapy ◽  
Scale Up ◽  
Economic Evaluations ◽  
People Living With Hiv ◽  
Cad Model ◽  
Community Based ◽  
Quasi Experimental ◽  
Living With Hiv ◽  
Art Delivery

Abstract Background Multi-month dispensing (MMD) is the mainstay mechanism for clinically stable people living with HIV in Cambodia to refill antiretroviral therapy (ART) every 3-6 months. However, less frequent ART dispensing through the community-based ART delivery (CAD) model could further reduce the clients’ and health facilities’ burden. While community-based services have been recognized as an integral component of HIV response in Cambodia, their role and effectiveness in ART delivery have yet to be systematically assessed. This study aims to evaluate the CAD model’s effectiveness on the continuum of care and treatment outcomes for stable people living with HIV in Cambodia. Methods We will conduct this quasi-experimental study in 20 ART clinics across the capital city and nine provinces between May 2021 and April 2023. Study sites were purposively selected based on the availability of implementing partners, the number of people living with HIV each clinic serves, and the accessibility of the clinics. In the intervention arm, approximately 2000 stable people living with HIV will receive ART and services from the CAD model. Another 2000 stable people living with HIV in the control arm will receive MMD—a standard care model for stable people living with HIV. The primary outcomes will be retention in care, viral load suppression, and adherence to ART. The secondary endpoints will include health providers’ work burden, the model’s cost-effectiveness, quality of life, mental health, social support, stigma, and discrimination. We will compare the outcome indicators within each arm at baseline, midline, and endline using descriptive and inferential statistics. We will evaluate the differences between the intervention and control arms using the difference-in-differences method. We will perform economic evaluations to determine if the intervention is cost-effective. Discussion This study will build the evidence base for future implementation and scale-up of CAD model in Cambodia and other similar settings. Furthermore, it will strengthen engagements with community stakeholders and further improve community mobilization, a vital pillar of the Cambodian HIV response. Trial registration ClinicalTrials.gov, NCT04766710. Registered 23 February 2021, Version 1.

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