PARTICIPATING IN HEALTH INSURANCE AND FACTORS AFFECTING AMONG PERSONS WHOSE ENROLMENT IS VOLUNTARY IN THUA THIEN HUE PROVINCE

2015 ◽  
pp. 89-95
Author(s):  
Thi Hoai Thuong Nguyen ◽  
Hoang Lan Nguyen ◽  
Mau Duyen Nguyen

Background:To provide information helps building policy that meets the practical situation and needs of the people with the aim at achieving the goal of universal health insurance coverage, we conducted this study with two objectives (1) To determine the rate of participating health insurance among persons whose enrolment is voluntary in some districts of ThuaThien Hue province; (2) To investigate factor affecting their participation in health insurance. Materials and Methodology:A cross-sectional descriptive study was conducted in three districts / towns / city of ThuaThien Hue in 2014. 480 subjects in the voluntary participation group who were randomly selected from the study settings were directly interviewed to collect information on the social, economic, health insurance participation and knowledge of health insurance. Test χ2 was used to identify factors related to the participation in health insurance of the study subjects. Results:42.5% of respondents were covered by health insurance scheme. Factors related to their participation were the resident location (p = 0.042); gender (p = 0.004), age (p <0.001), chronic disease (p <0.001), economic conditions (p<0.001) and knowledge about health insurance (p <0.001). Conclusion: The rate of participating health insurance among study subjects was low at 42,5%. There was "adverse selection" in health insurance scheme among voluntary participating persons. Providing knowledge about health insurance should be one of solutions to improve effectively these problems. Key words: Health insurance, voluntary, Thua Thien Hue

2019 ◽  
Vol 2 ◽  
pp. 32-41
Author(s):  
Gita Devi Ghimire ◽  
Suresh Raj Paudel

The main objective of this paper is to assess the level of patient satisfaction, to assess barriers faced by users of social health insurance during receiving treatment in the hospital, and to find out the relationship of participants' satisfaction with their selected demographic variables. This paper is a cross-sectional descriptive study and covers 354 samples that were selected by systematic sampling technique. The modified version of Assessment of Patients Satisfaction Scale (SAPS) consisting of seven structured items is used to collect the data through the face to face interview. The results of the study indicated that 158 (44.6%) participants are between the age group of 40-59 years and the majority of them i.e. 232 (65.5%) are females. Out of 354, most of the participants 292 (82.5%) are enrolled in the social health insurance scheme for more than 6 months. The study findings indicated that more than half 186 (52.5%) participants are satisfied, followed by 152 (42.9%) are dissatisfied, and 16(4.5%) of participants are very dissatisfied with the treatment service under the social health insurance respectively. The most common barriers faced by the participants while utilizing the health insurance services are unavailability of necessary drugs, long waiting times, limited opening hours, and complex billing system for insurance patients. Hence, the service availability time should be extended and availability of health personnel, medicines as well as other services should be improved that can increase satisfaction among users of health insurance.


2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Martin Amogre Ayanore ◽  
Milena Pavlova ◽  
Nuworza Kugbey ◽  
Adam Fusheini ◽  
John Tetteh ◽  
...  

Abstract Background Ghana’s National Health Insurance Scheme has improved access to care, although equity and sustainability issues remain. This study examined health insurance coverage, type of payment for health insurance and reasons for being uninsured under the National Health Insurance Scheme in Ghana. Methods The 2014 Ghana Demographic Health Survey datasets with information for 9396 women and 3855 men were analyzed. The study employed cross-sectional national representative data. The frequency distribution of socio-demographics and health insurance coverage differentials among men and women is first presented. Further statistical analysis applies a two-stage probit Hackman selection model to determine socio-demographic factors associated with type of payment for insurance and reasons for not insured among men and women under the National Health insurance Scheme in Ghana. The selection equation in the Hackman selection model also shows the association between insurance status and socio-demographic factors. Results About 66.0% of women and 52.6% of men were covered by health insurance. Wealth status determined insurance status, with poorest, poorer and middle-income groups being less likely to pay themselves for insurance. Women never in union and widowed women were less likely to be covered relative to married women although this group was more likely to pay NHIS premiums themselves. Wealth status (poorest, poorer and middle-income) was associated with non-affordability as a reason for being not insured. Geographic disparities were also found. Rural men and nulliparous women were also more likely to mention no need of insurance as a reason of being uninsured. Conclusion Tailored policies to reduce delays in membership enrolment, improve positive perceptions and awareness of National Health Insurance Scheme in reducing catastrophic spending and addressing financial barriers for enrolment among some groups can be positive precursors to improve trust and enrolments and address broad equity concerns regarding the National Health Insurance Scheme.


2021 ◽  
Vol 3 (1) ◽  
pp. 82-90
Author(s):  
Rolle Remi Ahuru ◽  
◽  
Osaze Daniel ◽  
Henry Akpojubaro Efegbere ◽  
◽  
...  

Purpose Health insurance reduces the cost of using modern maternal and child cares and encourages women to use modern care services. This is because health insurance scheme spread the burden of maternal care usage across people and overtime. In Nigeria, there is a dearth of research evidence on the effect of health insurance enrolment on maternal and childcare use. This study examined the effect of health insurance coverage on maternal and childcare use in Nigeria, drawing upon data from the most recent National Demographic and Health Survey (2018). Methods Three outcome indicators were used: a minimum of four antenatal care (ANC) visits, place of delivery, and complete child immunization. Descriptive and predictive analytical methods were utilized. A representative sample of 33,715 women who reported recent birth within the last five years preceding the Survey was used for the analyses. Analyses were undertaken using STATA version 13.0 for windows. Results The results showed that 57% of the women made a minimum of four ANC visits, 41% delivered in health institutions, and 27% undertook complete child immunization. Enrolment in health insurance was low as only 2.3% of the women were under any form of health insurance coverage. However, enrolment in health insurance significantly improves the odds for a minimum of four ANC visits [aOR: 1.52, p = 0.00] and health facility delivery [aOR: 1.42, p = 0.00]. However, there is no significant difference in complete child immunization between women who were under health insurance and those who were not [aOR: 1.36, p = 0.28]. Also, residing in an urban area, Southern geopolitical zones, and being drawn from wealthy homes confer an advantage on women to use modern maternal and child healthcare. Conclusion Pragmatic interventions should be initiated to encourage women’s enrolment in health insurance in Nigeria. Community-based health insurance scheme should be encouraged among rural women and those of them in the informal sector.


2021 ◽  
Vol 1 (11) ◽  
pp. e0000057
Author(s):  
Oladimeji Akeem Bolarinwa ◽  
Soter Ameh ◽  
Caleb Ochimana ◽  
Abayomi Olabayo Oluwasanu ◽  
Okello Samson ◽  
...  

Willingness and ability to pay for insurance that would cover primary healthcare services has not been evaluated consistently in different African communities. We conducted a cross-sectional community health survey and examined willingness and ability to pay in 3676 adults in seven communities in four countries: Nigeria, Tanzania, Uganda and Kenya. We used an open-ended contingency valuation method to estimate willingness to pay and examined ability to pay indirectly by calculating the ratio of healthcare expenditure to total household income. Slightly more than three quarters (78.8%) of participants were willing to pay for a health insurance scheme, and just a little above half (54.7%) were willing to pay for all household members. Across sites, median amount willing to pay was $2 per person per month. A little above half (57.6%) of households in Nigeria were able to pay the premium. The main predictors of likelihood of being unwilling to pay for the health insurance scheme were increasing age [aOR 0.99 (95% CI 0.98, 1.00)], being female [0.68 (0.51, 0.92], single [0.32 (0.21, 0.49)], unemployment [0.54 (0.34, 0.85)], being enrolled in another health insurance scheme [0.45 (0.28, 0.74)] and spending more on healthcare [1.00 (0.99, 1.00)]. But being widow [2.31 (1.30, 4.10)] and those with primary and secondary education [2.23 (1.54, 3.22)] had increased likelihood of being willing to pay for health insurance scheme. Retired respondents [adjusted mean difference $-3.79 (-7.56, -0.02)], those with primary or secondary education [$-3.05 (-5.42, -0.68)] and those with high healthcare expenditure [$0.02 (0.00, 0.04)] predicted amount willing to pay for health insurance scheme. The willingness to pay for health insurance scheme is high among the seven communities studied in East and West Africa with socio-demography, economic and healthcare cost as main predictive factors.


BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e031543 ◽  
Author(s):  
Peter O Otieno ◽  
Elvis Omondi Achach Wambiya ◽  
Shukri F Mohamed ◽  
Hermann Pythagore Pierre Donfouet ◽  
Martin K Mutua

ObjectiveTo determine the prevalence of health insurance and associated factors among households in urban slum settings in Nairobi, Kenya.DesignThe data for this study are from a cross-sectional survey of adults aged 18 years or older from randomly selected households in Viwandani slums (Nairobi, Kenya). Respondents participated in the Lown scholars’ study conducted between June and July 2018.SettingThe Lown scholars’ survey was nested in the Nairobi Urban Health and Demographic Surveillance System in Viwandani slums in Nairobi, Kenya.ParticipantsA total of 300 randomly sampled households participated in the survey. The study respondents comprised of either the household head, their spouses or credible adult household members.Primary outcome measureThe primary outcome of this study was enrolment in a health insurance programme. The households were classified into two groups: those having at least one member covered by health insurance and those without any health insurance cover.ResultsThe prevalence of health insurance in the sample was 43%. Being unemployed (adjusted OR (aOR) 0.17; p<0.05; 95% CI 0.06 to 0.47) and seeking care from a public health facility (aOR 0.50; p<0.05; 95% CI 0.28 to 0.89) was significantly associated with lower odds of having a health insurance cover. The odds of having a health insurance cover were significantly lower among respondents who perceived their health status as good (aOR 0.62; p<0.05; 95% CI 1.17 to 5.66) and those who were unsatisfied with the cost of seeking primary care (aOR 0.34; p<0.05; 95% CI 0.17 to 0.69).ConclusionsHealth insurance coverage in Viwandani slums in Nairobi, Kenya, is low. As universal health coverage becomes the growing focus of Kenya’s ‘Big Four Agenda’ for socioeconomic transformation, integrating enabling and need factors in the design of the national health insurance package may scale-up social health protection.


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