dc.description.abstract |
As of literatures, the implementation of a given program is constrained by social,
political, demographic and economic factors. But, to understand the extent of the
constraints, the current performance of a program and shape future target area
by learning from mistakes, well organized study is necessary to be undertaken.
Thus, this paper is aimed to study the Determinants of Community Based Health
Insurance program implementation in selected rural kebeles of Ebinat woreda in
Amhara region adding to the available literatures previously done. Many
people’s study was very limited to identifying participation factors but, this one
also focuses on the implementation of the scheme along with identifying the
threats of drop out of participants using component analysis. Thus, the target
population in the study includes members and non-members. Binary logistic
regression model was used to identify the factors related to the decision to be
members along with factor analysis in identifying the issues associated with drop
out of the scheme. Questionnaire of mixed nature along with focused group
discussion is used and data has been collected from randomly selected
households. The performance of the district in the membership into the health
scheme has been found to be 65% and 71% in terms of renewal. After the logistic
regression, sex of the household head, fatal disease, family size, disability,
monthly income of the household (negatively), distance (negatively) and level of
awareness(very good category) are found statistically significantly affecting the
variation of the membership decision of households. Moreover, the factor analysis
showed that both quality service delivery, awareness related and premium related
issues are the bottlenecks for the implementation of the scheme. Based on these
results, it is concluded that there are supply side and demand side factors
affecting both the membership and drop out threats from health insurance
scheme. Thus, it is recommended to take actions on statistically significant issues
like distance from health center, very good awareness, fatal disease and the like
to have better performance. |
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