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Community-based health insurance and communities' scheme requirement compliance in Thehuldere district, northeast Ethiopia: cross-sectional community-based study

Authors Workneh SG, Biks GA, Woreta SA

Received 8 March 2017

Accepted for publication 11 May 2017

Published 14 June 2017 Volume 2017:9 Pages 353—359

DOI https://doi.org/10.2147/CEOR.S136508

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Lucy Goodman

Peer reviewer comments 2

Editor who approved publication: Professor Giorgio Lorenzo Colombo

Samuel Getachew Workneh,1 Gashaw Andargie Biks,2 Solomon Assefa Woreta3

1Clinton Health Access Initiative Child Survival Program, Bahir Dar, Ethiopia; 2Department of Health Management and Health Economics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia; 3Department of Health Informatics, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia

Background: Community-based health insurance (CBHI) is becoming a prominent and promising concept in tackling financial health care issues confronting the poor rural communities in developing countries. Ethiopia endorsed and constituted CBHI schemes in 13 pilot “woredas” in 2010/11. This study aimed to assess the compliance of the community to CBHI scheme requirements in Thehuledere district, northeast Ethiopia.
Methods: A community-based cross-sectional study was conducted among 530 respondents between April and June 2015 in Thehuledere District, South Wollo Zone, northeast Ethiopia. A systematic random sampling technique was deployed to select the study participants. A self-administered, structured, pre-tested questionnaire was used to collect the data. Bivariate and multivariate logistic regression analyses were used to identify factors associated with CBHI compliance.
Results: A total of 511 study participants were included in the study. Approximately 77.9% of the study population complied with CBHI requirements: members’ age (AOR = 0.74, 95% CI: 0.62–0.8), premium fee affordability (AOR: 2.66, 95% CI: [1.13–4.42]), members’ occupation (AOR = 0.14, 95% CI: 0.04–0.45), members’ attitude toward CBHI management (AOR = 2.11 [1.14–3.90]), and CBHI members’ knowledge (AOR = 0.24, 95% CI: [0.13–0.42]) were found to be major predictors of community compliance to CBHI requirements.
Conclusion: CBHI requirement compliance at the early stage was relatively high. We observed that members’ age, premium fee affordability, occupation, attitude, and knowledge were significant predictors. CBHI management’s involvement in awareness creation and training on requirements of the CBHI scheme would contribute to better outcomes and success.

Keywords:
compliance, community-based health insurance, Ethiopia

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