Acceptance of the proposed social health insurance among government-owned company employees in Northwest Ethiopia: implications for starting social health insurance implementation

Abstract

Background Ethiopia is currently planning to introduce Social Health Insurance (SHI) that will lead to universal health coverage and assist a country to achieve its health system’s objectives and to prevent the catastrophic health expenditure. But there is no evidence until now about the level of acceptance of the proposed SHI among government-owned companies’ employees. Therefore, this study was intended to assess the acceptance of SHI and associated factors among government-owned companies’ employees in northwest Ethiopia. Methods An institution-based cross-sectional study was conducted from February 1 to April 30, 2019. A randomly selected 541 government-owned companies’ employees were participated in the study. A pretested self-administered structured questionnaire was used that consisted sociodemographic and economic, health status-related factors, attitude (measured by 12 items), organizational related factors and knowledge about SHI (measured by 11 items). Finally, binary logistic regression analysis was performed and in the multivariable logistic regression analysis, a significant level at a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI) were used to identify factors statistically associated with SHI acceptance. Results Overall, 32% (95% CI: 27.7–36.2) of the government-owned companies’ employees accepted the proposed Ethiopian SHI scheme. Self-perceived health status (AOR: 8.55, 95% CI: 2.69–27.13), heard about SHI (AOR: 1.69, 95% CI: 1.12–2.54), coverage of medical healthcare cost (AOR: 0.60, 95% CI: 0.39–0.92), work experience (AOR: 0.49, 95% CI: 0.26–0.89) and quality of healthcare service at the facilities (AOR: 0.17, 95% CI: 0.04–0.71) were significantly associated with acceptance of SHI among government-owned companies’ employees. Conclusions One-third of the study participants accepted the proposed Ethiopian SHI scheme. Self-perceived health status, quality of healthcare service at health facilities, coverage of the medical cost by their organization, heard about SHI and work experience were the factors that affect acceptance of the proposed SHI among the government-owned company employees. Therefore, policymakers should devise a plan to promote the benefit packages of SHI for the formal sector employees to start the implementation.

Willingness to pay for social health insurance among public civil servants: A cross-sectional study in Dessie City Administration, North-East Ethiopia

“…The total magnitude of WTP for SHI was 29.6%, with age, positive view of SHI, acute illness, level of education, and net family income being the factors that were significantly linked with the WTP for SHI. This was slightly similar to the findings of other studies conducted in Debere Berhan, Ethiopia (27.8%) ( 30 ) and Northwest Ethiopia (32%) ( 19 ). This result was discovered to be higher than that of studies conducted in Arba Minch, Southern Ethiopia (5.9%) ( 31 ) and at St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia (17%) ( 32 ), but significantly lower than the findings of many other studies in Jimma, Southwest Ethiopia (90%) ( 13 ), Wolaita Sodo, South Ethiopia (74.4%) ( 15 ), Gondar, Northwest Ethiopia (62.0%) ( 11 ), Mekelle, Northern Ethiopia (85.3%) ( 23 ), Mujja, Ethiopia (37.6%) ( 33 ), Bahir Dar, Northwest Ethiopia (66.6%) ( 20 ), Mekelle, Northern Ethiopia (74.9%) ( 18 ), and public hospitals of Tigrai, Northern Ethiopia (35.5%) ( 34 ).…”

“…The perceived quality of health-care services, on the other hand, was found to raise the WTP for SHI ( 18 ). It has also been reported that the ease with which past medical healthcare costs can be covered has a negative impact on the decision to pay for SHI ( 19 ). Alternatively, they may not have a history of financial difficulties in paying medical expenditures ( 18 ).…”

“…That is, if the ill persons' healthcare costs are discovered to be too low, they may choose OOP. This will result in a negative decision to pay for the scheme, despite the fact that high-quality healthcare services may be available at the facilities ( 19 ). On the contrary, if there has been a history of high OOP healthcare costs, the plan's WTP may be favorable ( 32 ).…”

Willingness to Pay for Social Health Insurance and Its Determinants Among Public School Teachers in Akaki Kality Sub-City of Addis Ababa City Administration: Ethiopia. Institution-based cross-sectional study

“…Self-rated perceived their health status was bad (73.9%) among Akaki Kality public school teachers in contrast to the previous study ndings, which was better among health professionals in government hospitals in Mekelle City for 87.5%[26] and among government-owned company employees in Northwest Ethiopia for 94.1% [27]; this might be due to the difference of target participant, time of study (COVID-19 outbreak era) and the institutions. The OOP payments for healthcare expenditures for teachers is 88.4%; which is lower compared to study on the willingness to pay for SHI among women from low-income HHs of Karachi, Pakistan (91%)[28] and a survey on long term health spending for individuals leaving in 11 emerging nations/countries with emerging economies paid 75.1-97.7% of their private healthcare expenditures was from direct OOP [16].…”

The Magnitude of Perceived Professionalism and Its Associated Factors Among Nurses in Public Referral Hospitals of West Amhara, Ethiopia

“…Life insurance: the medical services given by the nurse within the working health institution. 21 Prospective views of the nursing profession: the better future view of the nurses toward the nursing profession. 2 Membership to the community: any members of health associations in the community such as the Ethiopian Nursing Association, to ease any collaborative work.…”