Abstract:
Background: Community-based health insurance scheme is now becoming gradually more recognized as a tool to finance health care in developing countries establishing through members by participating every process and activities of the scheme.
Objective: The aim of this study is to assess communities’ willingness to enroll for community-based health insurance and its associated factors in Simada district, Northwest, Ethiopia.
Method: A community-based mixed cross- sectional study design was conducted. The sample size were 510, multistage simple random and perpusive sampling techinque were used for quantitative and qualitative studies respectivly. The structured interviewer administer questionnaires were used. The data were coded and entered to Epi info version 7.2.0.1 and exported to SPSS 20.0 for data analysis. Inferential statistics were done to determine an association between the outcome and independent variables. Statistically significant variables in bivariate logistic regression analysis with p-value <0.2 were entered for multivariable binary logistic regression analysis and P-value ≤ 0.05 was considered as statistically significant and Hosmer and Lemeshow's goodness of fitness test was fitted and qualitative data were analyzed by using thematic analysis.
Result: Among 510 study participants 454 (89%) [CI: (86.5%-91.6%)] were willing to enroll for community-based health insurance. After adjusting potential confounders in multivariable logistic regression family wealth, social capital, chronic illness, family size and distance from health facility were significantly associated with willingness to enroll for community based health insurance. On qualitative aspect, feeling on family wealth, membership of Iddir, presence of chronic diseases, and pressure from agents were factors to enroll.
Conclusion: Willingness to enroll for community-based health insurance in the study area is high. Members of Social capital, experience of chronic illness in the households, nearest live to the health facility, less than five family members and medium wealth status of the family were factors found to be associated with willingness to enroll for the scheme and giving emphasis on redesigning, planning strategies for better expanding the scheme accordingly.
Keywords: Community- based health insurance, Ethiopia, Simada district, Willingness to enroll