Exploring The Facilitators of Community-Based Health Insurance Scheme Bankruptcy and its Magnitude in North Mecha District, West Gojjam Zone, Amhara, Ethiopia, 2021.

Chernet, Mengistie

dc.contributor.author	Chernet, Mengistie
dc.date.accessioned	2022-06-27T12:51:52Z
dc.date.available	2022-06-27T12:51:52Z
dc.date.issued	2022-04
dc.identifier.uri	http://ir.bdu.edu.et/handle/123456789/13822
dc.description.abstract	Background: Health insurance, is a type of insurance that covers medical expenses that arise due to an illness. Ethiopia since 2011, piloting community-based health insurance by 13 woredas, now the program has been expanding to 1100 woredas. The schemes are currently becoming financially unsustainable. Nationally the proportion of schemes with a negative financial balance was increasing, reaching close to 10% of schemes in 2018/19. In the Amhara region, from a total of 184 active schemes, about 54 were bankrupted. It was estimated 210 million birrs. But, the reason behind this is not explored. Objective: To explore the facilitators of the Community Based Health Insurance Scheme Bankruptcy and its magnitude in North Mecha District, West Gojjam Zone, Amhara, Ethiopia, 2021. Method: Mixed study design was used. Data were collected by using a semi-structured questionnaire using Key informant interviews for qualitative methods and document reviews for quantitative data. Data were analyzed using a qualitative data analysis software package atlas ti and for the quantitative method, data were entered into excel and descriptive analysis was performed. Results: The study revealed that low enrollment rate, low contribution amount and subsidy, too many benefit packages, fraud and moral hazards demand and supply side, low availability of drugs and laboratory services, increased cost of medical supply and health care services, low community awareness, and increased health service utilization was identified the main facilitators of Community Based Health Insurance bankruptcy. The schemes expenditure to revenue ratio was 1.5 and higher with the national target of 0.95. Conclusions: In conclusion, this study’s findings explored program related, community related, provider related, and health insurance scheme related factors were identified as facilitating for scheme bankruptcy. These facilitating factors would need policy shift and program redesign. Finally, research and academic work must focus on studying and addressing the financial sustainability of the schemes and the capacity of members to contribute for membership. This should be done with the health system and various stakeholders like the government, and NGO’s. Keywords: Health insurance, Adverse selection, capitation, Contributions, Target subsidies, General subsidies, Extra/Additional family member and bankruptcy	en_US
dc.language.iso	en	en_US
dc.subject	Health Systems Management and Health Economics	en_US
dc.title	Exploring The Facilitators of Community-Based Health Insurance Scheme Bankruptcy and its Magnitude in North Mecha District, West Gojjam Zone, Amhara, Ethiopia, 2021.	en_US
dc.type	Thesis	en_US