The effects of individual and community-level factors on community-based health insurance enrollment of households in Ethiopia

Abstract

Introduction Community-based health insurance (CBHI) is a type of volunteer health insurance that has been adopted all over the world in which people of the community pool funds to protect themselves from the high costs of seeking medical care and treatment for the disease. In Ethiopia, healthcare services are underutilized due to a lack of resources in the healthcare system. The study aims to identify the individual and community level factors associated with community-based health insurance enrollment of households in Ethiopia. Methods Data from the Ethiopian mini demographic and health survey 2019 were used to identify factors associated with community-based health insurance enrollment of households in Ethiopia. Multilevel logistic regression analysis was used on a nationally representative sample of 8,663 households nested within 305 communities, considering the data’s layered structure. We used a p-value<0.05 with a 95% confidence interval for the results. Result The prevalence of community-based health insurance enrollment in Ethiopia was 20.2%. The enrollment rate of households in the scheme was high in both Amhara (57.9), and Tigray (57.9%) regions and low (3.0%) in the Afar region. At the individual level; the age of household heads, number of children 5 and under, number of household members, has land for agriculture, has a mobile telephone, receiving cash of food from the safety Net Program, Owning livestock, and herds of farm animals, wealth index, and at the community level; the region had a significant association with community-based health insurance enrollment. Conclusion Both individual and community-level characteristics were significant predictors of community-based health insurance enrollment in households. Furthermore, the ministry of health, health bureaus, and other concerning bodies prioritize clusters with low health insurance coverage to strengthen health system financing and intervene in factors that negatively affect the CBHI enrollment of households.

Factors affecting community-based health insurance utilization among households in Degadamot District, Ethiopia: Community-based cross sectional study

“…This study demonstrated that participants who had primary education (2.10 times) and secondary or higher education (2.5 times) were four times more likely to be CBHI members than those who did not have formal education. This study was in agreement with a study conducted in Ethiopia [15,18,20], Kenya [28], and Sri Lanka [29].…”

“…In this study, household heads aged 20-29 years were 37% less likely to use CBHI than those aged 60-70 years, while those aged 30-39 years (1.78 times), 40-50 years (1.64 times), and 50-60 years (1.04 times) were more likely to use CBHI than those aged 60-70 years. This nding was consistent with Jimma Zone [20], 60-year-old and older households were more likely to use CBHI than younger households, and Ethiopian MEDHS, 2019 [21,22]. However, this nding was not consistent with studies in the Gidda Ayana District [23].…”

Determinants of Uptake of Community-Based Health Insurance in the Bamenda Ecclesiastical Province Health Assistance

“…Demographic characteristics have been applied in many of these studies and found to produce differing results. Alesane and Anang (2018), Masengeli et al (2017), Kimani et al (2014Kimani et al ( , 2012 find a positive relationship between age and insurance uptake supported by Conde et al (2022) and Moyehodie et al (2022) as opposed to Mé dard and Rodrigue (2021) who find a negative relationship between age and insurance uptake. Also, the study of Masengeli et al (2017) did not find any significant difference in health insurance uptake on the basis of gender of respondents.…”

Emerging trends and patterns in healthcare-seeking behavior: A systematic review

“…Conversations between parents who have more knowledge about depression treatment and adolescents are associated with greater knowledge and a higher willingness to seek treatment for depression. Moyehodie [34] revealed that both individual and community-level factors are important predictors of community-based health insurance enrollment in families. Park [35] emphasized the importance of considering shared cultural beliefs and stigma within ethnic communities when addressing mental health issues and promoting the use of mental health services.…”

“…In terms of the geographical distribution of scientific achievements (as shown in Table 1), the United States has the highest number of publications, with 82 documents, followed by China (34), Australia (6), and the United Kingdom (5). This may reflect the attention and investment of these countries in the field of healthcare and medical research over the past few decades.…”