Willingness to join and pay for Social Health Insurance  among Public Servants in Arba Minch town, Gammo Zone, Southern Ethiopia

Abstract

Background Ethiopia plans to introduce social health insurance scheme for the formal sector. The scheme contribution will be collected as 3% of an employee’s monthly gross salary from both employee and employer. The scheme is expected to enhance access to health care, however, there is a concern that majority of civil servants were not willing to join and pay for it. Therefore, this study aims to assess willingness to join and pay for the newly proposed social health insurance among public servants in Arba Minch town, Southern Ethiopia.Methods Institution based, Cross-sectional study design was used among 713 randomly selected public servants in Arba Minch town. Multi-stage stratified random sampling technique was used to select participants. Data were collected by using a pre-tested, self-administered, structured questionnaire and then it was cleaned, coded, entered in to Epidata v.3.2 and exported to SPSS version 25 statistical package for analysis. Multivariate logistic regression was used to identify the predictors of willingness to join and pay for Social Health Insurance. Odds ratio less than 0.05 was used as cut-off point and 95% CI was used to report the finding. Open question contingent valuation method was also used to analyze willingness to pay for the scheme.Result Among the total of 692 respondents, 254 (36.7%) were willing to join the scheme. Out of those who were willing to join 171 (24.7%) respondents were willing to pay less than 1% and 41(5.9%) respondents were willing to pay 2–3% of their gross monthly salary. Interest to join the scheme was found to be affected by an awareness of the scheme, household size, regularly listening for health information and participation in the social network.Conclusion There is limited knowledge and awareness about the design of health issuance. Majority of the respondents were not willing to join and pay the proposed amount for the scheme. Provision of health information on mass media could be used as one strategy to enhance the understanding of health insurance and to change perception on social health insurance scheme.

Willingness to Pay for Social Health Insurance Among Health Care Professionals in North Wollo Zone, Amhara Region, Ethiopia: Mixed Method Study

“…This study found that 61.7% of the participants were willing to join and pay the proposed SHI. This is relatively in line with the study results from Debre Markos, which were 69.8%, 19 and South Sudan, which were 68.8%, 24 but it is relatively higher compared to previous studies in Addis Ababa, which were 28.7%, 14 and Arba Minch, which were 36.7%, 25 but it is lower than the study results from Mekele, which were 85.3% 21 and Gondar, which were 80%. 26 The variation could be due to different research times, places, methodologies, and participants’ understanding of the value of the SHI system, rising healthcare expenses, or it could be because HCP obtains free health services as a result; they rely on the free health services rather than the SHI scheme.…”

“…This is consistent with the study result conducted in Arba Minch. 25 The likelihood of needing healthcare services is higher for individuals with children under the age of five since the possibility of illness is higher. As a result, their desire to join and pay would be higher to avoid future medical costs.…”

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

“…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). When compared to other findings outside Ethiopia, such as in Akwa Ibom State, Nigeria (82%) (35), Sarawak, Malaysia (46.7%) (16), Bangladesh (67.5%) (36), Juba City, South Sudan (68%) (37), Public University in Malaysia (72.5%) (38), Pokhara Lekhnath, Nepal (51%) (39), Kampala, Uganda (91%) (40), and central Vietnam (71.6%) (41), the WTP for SHI in this study was very low.…”

Willingness to pay for social health insurance in Ethiopia: A systematic review and meta-analysis

“…The WTP for SHI was found to be influenced by sociodemographic factors like education level ( 20 – 22 , 25 , 31 , 32 ), income ( 17 , 19 – 21 , 27 , 28 , 31 , 34 ), age ( 26 , 28 , 31 ), marital status ( 28 , 33 ), occupation or job description ( 28 ), family size ( 29 , 30 , 34 ), and job experience ( 16 ); health and illness status such as self-rated healthiness ( 16 ), the presence of acute ( 20 , 21 , 31 ), and chronic illnesses ( 34 ); health service related factors like previous medical bills ( 16 , 18 , 21 , 22 , 24 , 27 , 28 , 30 , 35 ), referral system ( 26 ), regular medical checkup ( 26 ), and health service quality ( 16 , 19 , 24 – 27 ); awareness or knowledge ( 16 – 18 , 20 – 23 , 27 , 29 , 30 , 32 , 34 , 35 ); perception ( 24 , 31 ); attitude ( 17 , 21 , 27 , 33 , 34 ); and factors related to the scheme such as trust ( 17 , 23 ), premium amount ( 19 ), and the scope of the benefit packages ( …”