Research Article - Journal of Public Health Policy and Planning (2025) Volume 8, Issue 4

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

Background: Community-based health insurance is provided in several countries as part of the overall health funding approach, Including Ethiopia. Ethiopia has been utilizing the basic healthcare model and has endured a number of fundamental issues, such as insufficient service coverage, unequal access, and high out-of-pocket expenses. However, there are few studies showed that low CBHI enrolment. However, enrolment is a progressive activity, and there is updated evidence about factors of enrolment.

Objective: This study was focused on the factors affecting community-based health insurance enrolment among households in Degadamot district, Ethiopia in 2022. Methods: A community-based cross-sectional study was employed among 736 households from August 15 to October 15,2022. Participants were screened by using a two-stage sampling technique. Data were collected using interviewer-administered pre-tested questionnaire and entered into EPI-Info 7 and transported to SPSS version 26. Multi-variable logistic regression was performed to further analysis. A p-value less than 0.05 with a 95% confidence interval accounted significantly factors for dependent variables.

Result: The multivariate logistic regression analysis was showed that participants who were aged in years of 35-54 years (AOR=2.89; 95% CI: 1.78, 4.69), 55-74 years (AOR=3.84; 95% CI: 2.18, 6.75), >=75 years (AOR=2.25; 95% CI: 1.04, 4.89), family size of households who had 5 and above members (AOR=2.06; 95% CI: 1.43-2.95), primary education (AOR=2.10; 1.43, 2.95), secondary and above education(AOR=2.50; 95% CI: 1.88, 4.99), had own land (AOR: 1.62; 95% CI: 1.26, 3.54), had own domestic animals (AOR=2.11; 95% CI: 1.26, 3.54), enrolled in Safety net program (AOR=2.80; 95% CI: 1.52-5.15) and had good knowledge about CBHI (AOR=3.16; 95% CI: 2.08, 4.45) factors were significantly associated with CBHI enrollment.

Conclusion: community-based health insurance enrolment was affected by factors with age, family size, residence, educational status, owning land and domestic animals, and being enrolled in the safety net program and had good knowledge about CBHI were associated with CBHI enrolment. Hence, a strong monitoring and evaluation system, strategies to design to increase awareness levels about the CBHI scheme's benefits, special considerations for young age people, community based education and collaboration with social security sectors.

Author(s):

Melesse Belayneh, Mastewal Tamiru

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