The effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia: A cross sectional study

Abstract Background Globally, Millions of people cannot use health services because of the fear of payment for the service at the time of service delivery. From the agenda of transformation and the current situation of urbanization as well as to ensure universal health coverage implementing this program to the urban resident is mandatory. The aim of this study is to assess the willingness of community-based health insurance (CBHI) uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, 2018. Methods A community-based cross-sectional study was conducted. From the total of eighteen towns; six towns which account for 33% of the total were selected randomly for the study. One population proportion formula was employed to get a total of 845 households. A pre-tested, semi-structured interviewer-administered questionnaire was used to collect the required data. Double-Bounded Dichotomous Choice Variant of the contingent valuation method was used to assess the maximum willingness to pay for the scheme, and a multiple logistic regression model was used to determine the effect of various factors on the willingness to join and willingness to pay for the households. Result About 839 (99.3%) of the respondents participated. The mean ages of the respondents were 40.44(SD ± 11.12) years. 621 (74.1%) ever heard about CBHI with 473 (56.3%) knowing the benefits package. Out of 839, 724 (86.3%) were willing to uptake CBHI of which 704 (83.9%) were willing to pay if CBHI established in their town. Conclusion If CBHI established about 86.3% of the households would enroll in the scheme. Having education, with a family size between 3 & 6, having difficulty in paying for health care and less than 20mins it took to reach the nearest health facility were the independent predictors of the willingness of CBHI uptake. The Oromia and Towns Health Bureau should consider the availability of health facilities near to the community and establishing CBHI in the urban towns.

Download Full-text

Extent and determinants of catastrophic health expenditure for tuberculosis care in Chongqing municipality, China: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2018-026638 ◽

2019 ◽

Vol 9 (4) ◽

pp. e026638 ◽

Cited By ~ 6

Author(s):

Weixia Duan ◽

Wen Zhang ◽

Chengguo Wu ◽

Qingya Wang ◽

Ya Yu ◽

...

Keyword(s):

Health Insurance ◽

Health Expenditure ◽

Protective Factor ◽

Diagnostic Delay ◽

Cross Sectional Study ◽

Catastrophic Health Expenditure ◽

Patient Delay ◽

Sectional Study ◽

Cross Sectional ◽

Chongqing Municipality

ObjectiveTo investigate the extent and associations of patient/diagnostic delay and other potential factors with catastrophic health expenditure (CHE) for tuberculosis (TB) care in Chongqing municipality, China.DesignA cross-sectional study.SettingFour counties of Chongqing municipality, China.ParticipantsA total of 1199 patients with active pulmonary TB beyond 16 years and without mental disorders were consecutively recruited in the four counties’ designated TB medical institutions.Outcome measuresThe incidence and intensity of CHE for TB care were described. The association between patients’ ‘sociodemographic and clinical characteristics such as patient delay, diagnostic delay, forms of TB, health insurance status and hospitalisation and CHE were analysed using univariate and multivariate logistic regression.ResultsThe incidence of CHE was 52.8% and out-of-pocket (OOP) payments were 93% of the total costs for TB care. Compared with patients without delay, the incidence and intensity of CHE were higher in patients who had patient delay or diagnostic delay. Patients who experienced patient delay or diagnostic delay, who was a male, elderly (≥60 years), an inhabitant, a peasant, divorced/widow, the New Cooperative Medical Scheme membership had greater risks of incurring CHE for TB care. Having a higher educational level appeared to be a protective factor. However, hospitalisation was not associated with CHE after controlling for other variables.ConclusionThe incidence and intensity of CHE for TB care are high, which provides baseline data about catastrophic costs that TB-related households faced in Chongqing of China. Variety of determinants of CHE implicate that it is essential to take effective measures to promote early seeking care and early diagnosis, improve the actual reimbursement rates of health insurance, especially for outpatients, and need more fine-tuned interventions such as precise poverty alleviation to reduce catastrophic costs of the vulnerable population.

Download Full-text

Willingness to Enroll for Community-Based Health Insurance and Associated Factors in Simada District, North-West, Ethiopia, 2020:A Community-Based Cross-Sectional Study

Risk Management and Healthcare Policy ◽

10.2147/rmhp.s280685 ◽

2020 ◽

Vol Volume 13 ◽

pp. 3031-3038

Author(s):

Moges Yitayew ◽

Mohammed Adem ◽

Nigusie Selomon Tibebu

Keyword(s):

Health Insurance ◽

Associated Factors ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

North West ◽

Community Based Health Insurance ◽

North West Ethiopia

Download Full-text

Willingness to Join Community-Based Health Insurance and Factors Affect It Among Households of Selected Districts of West Shoa Zone, Ethiopia: A Community Based Cross Sectional Study

10.7176/jhmn/65-03 ◽

2019 ◽

Keyword(s):

Health Insurance ◽

Cross Sectional Study ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Community Based Health Insurance

Download Full-text

Willingness of Households to Pay Community Based Health Insurance and its Associated Factors in Mecha District, Northwest Ethiopia: Community based Cross-sectional Study

10.21203/rs.3.rs-182524/v1 ◽

2021 ◽

Author(s):

Getaneh Bizuayehu Demeke

Keyword(s):

Health Insurance ◽

Low Income ◽

Associated Factors ◽

Scale Up ◽

Cross Sectional Study ◽

Northwest Ethiopia ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Community Based Health Insurance

Abstract Background Community-based health insurance schemes helps to give financial protection and decrease direct out- of-pocket payment for health care based on the assumption of risk-pooling and community solidarity to risks of falling sick. Ethiopia is a low income country with more of health spending out of pocket payment by households. Community based health insurance was introduced in Ethiopia in 2010.It covers only the rural community and informal sector. Objectives this study aimed to assess willingness of households to pay community based health insurance and its associated factors in Mecha district, Northwest, Ethiopia. Methods Community based cross-sectional study design was used to collect data from 285 household heads using multistage sampling techniques in Mecha district Northwest Ethiopia. The data were collected by using trained data collectors and using a pre-tested structured questionnaire. A binary logistic regression model was used 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. Results From the total of 296 sampled respondents, 285 participated in the study with the response rate of 96.3%. Of these, 251(88.1%) were willing to join voluntary as well as 34(11.9%) were join mandatory and 256(89.8%) of them were willing to pay community based health insurance services. The average amount of money the households were willing to pay per household per annum was 334.02 ETB found with the interval of (317.32–351.30) with the range between 240–1000 ETB. Conclusions The willingness of house hold heads to pay for the community-based health insurance was high. Residence, join CBHI, premium affordable, CBHI have an advantage and distance from households home to HF were more willing to pay CBHI schemes. The study indicated that high willing to pay and low CBHI package fulfil the needs of HH treatment as well as overall CBHI service level was poor. Therefore, Mecha district CBHI coordinating office should be scale up the community-based health insurance services in the scheme.

Download Full-text

Maternal Characteristics Are Associated with Child Dietary Diversity Score, in Golina District, Northeast Ethiopia: A Community-Based Cross-Sectional Study

Journal of Nutrition and Metabolism ◽

10.1155/2020/6702036 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7

Author(s):

Getahun Fentaw Mulaw ◽

Fentaw Wassie Feleke ◽

Seteamlak Adane Masresha

Keyword(s):

Dietary Diversity ◽

Cross Sectional Study ◽

Nutrition Status ◽

Sectional Study ◽

Community Based ◽

Cross Sectional ◽

Maternal Characteristics ◽

Dietary Diversity Score ◽

Northeast Ethiopia ◽

Minimum Dietary Diversity

Background. Dietary diversity is part of the set of indicators developed to assess infant and young child feeding practices. In developing countries, only a quarter of children met the required minimum dietary diversity. In Ethiopia, only 14% of children aged 6–23 months met the minimum dietary diversity score, with regional variation. Therefore, this study aimed to assess dietary diversity score and associated factors among children aged 6–23 months in Golina district, Afar region, Ethiopia. Method. A community-based cross-sectional study was conducted among 345 study participants from February 15 to March 30, 2017, in Golina district, Afar, Northeast Ethiopia. The study kebeles were selected randomly and the study subjects were selected using a cluster sampling technique. The child dietary diversity score was determined by the WHO child dietary diversity score scale, using a 24-hour dietary recall method, and data were collected using an interviewer-administered questionnaire. Multivariable logistic regression was used to identify predictor variables, and the level of significance was determined at P value <0.05. Result. This study revealed that children who met the required minimum dietary diversity score were 35.1% (95% CI, (30%–40%)). Children whose mothers have not attended formal education were 3.042 times (AOR = 3.042 95% CI: (1.312–7.052)) less likely to meet the minimum dietary diversity score than children whose mothers have attended secondary and above. Children whose mothers had normal BMI were 51.2% (AOR = 0.488, 95% CI: (0.259–918)) and 68.1% (AOR = 0.319, 95% CI: (0.119–0.855)) more likely to meet the minimum dietary diversity score than children whose mothers’ BMI was underweight and overweight, respectively. Conclusion. Maternal characteristics (educational status and nutrition status) were found to be associated with their child's dietary diversity score. This study also revealed that children who met the minimum dietary diversity score were few. Therefore, the increased emphasis on the importance of the education of girls (future mothers) and nutrition counseling for girls/women who currently have received little education on ways to improve the family and child dietary feeding practice is needed.

Download Full-text