Willingness to Join and Pay for Community-Based Health Insurance Among Rural Households of Selected Districts of Jimma Zone, Southwest Ethiopia.

Globally, millions of people suffer and die because they do not have the money to pay for health care. A voluntary health insurance scheme is a prepayment mechanism to overcome the financial hardship of poor households. There is a high demand to determine the enrolment rate and ability to pay before scale-up of the scheme by the government to be sure of its feasibility and sustainability. To determine willingness to join and pay for a community-based health insurance scheme and associated factors among rural households of selected districts in Jimma Zone, 2018. A community-based cross-sectional study design was employed in selected districts of Jimma Zone, Ethiopia. Multistage simple random sampling was used to select 422 households. Data were collected using a semi-structured interviewer-administered questionnaire. A double bounded contingent valuation method was applied to elicit households' willingness to pay for the scheme. Data were entered into Epi-Data 3.1 and analyzed with SPSS V.23. A binary logistic regression model was fitted to determine the presence of statistically significant associations between the dependent and independent variables at p-value <0.05 and AOR values with 95% CI. Of 422 sampled respondents, 389 participated in this study with a response rate of 92%. Of these, 305 (78%) were willing to join and 274 (90%) of them were willing to pay. The average amount of money the households were willing to pay per household per annum was 228 ETB (8.27 USD), with a range of 100-500 ETB. The older age groups, poor households, and experience of local risk-sharing schemes were found to be determinants for willingness to join the community-based health insurance. Similarly, having a large family size, and low economic and education status of households were significant predictors of willingness to pay for this scheme. A high proportion of households were willing to join and pay for the CBHI scheme. The average amount of money they were willing to pay for the scheme was very slightly lower than what is planned by the government. Thus, the government of Ethiopia should strengthen efforts to scale up this scheme in the rural areas of the country specifically to districts not yet enrolled, to reduce direct out-of-pocket payment at service delivery points. This will also contribute to guaranteeing dwellers of rural areas access to quality health services without facing financial hardship, to achieve universal health coverage for all by the end of 2035.

Garedew MG ，Sinkie SO ，Handalo DM ，Salgedo WB ，Yitebarek Kehali K ，Kebene FG ，Waldemarium TD ，Mengesha MA ... -  《-》

Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia.

Kaso AW ，Haji A ，Hareru HE ，Hailu A ... -  《PLoS One》

Determinants of willingness to pay for community-based health insurance scheme among households in rural community of southern Ethiopia.

Abebe Y ，Belayneh F 《BMC HEALTH SERVICES RESEARCH》

Willingness to pay for community based health insurance scheme and factors associated with it among households in rural community of South West Shoa Zone, Ethiopia.

Out-of-pocket payments are the major significant barrier in achieving universal health coverage, particularly in developing countries' rural communities. In 2011, the Ethiopian government launched a pilot community-based health insurance (CBHI) scheme with the goal of increasing access to modern health care services and providing financial security to households in the informal sector and rural areas. The main objective of this study is to estimate willingness to pay (WTP) for CBHI scheme and factors that influence it among rural households in the South West Shoa Zone. A household-level cross-sectional study was conducted to examine the WTP for the CBHI scheme and factors associated with it in rural communities of South West Shoa Zone. The study used a sample of 400 rural households. Systematic random sampling was employed during household selection, and double-bounded contingent valuation method was used to estimate WTP for the CBHI scheme. About 65 percent of the households are willing to pay for CBHI scheme. Moreover, the study found that the households were willing to pay 255.55 Birr per year on average. The result of the study also revealed that amount of bid, household income, family size, household head's education, household health status, membership to community-based health insurance scheme, membership in any association, and awareness about the scheme are factors that are significantly associated with WTP for the scheme. Households are willing to pay a higher price than the policy price. Therefore, setting a new premium that reflects households' willingness to pay is highly valuable to policymakers. Social capital and awareness about CBHI scheme play an important role in influencing WTP. Thus, the study suggests that local communities need to strengthen their social cohesion and solidarity. It is also necessary to create awareness about the CBHI's benefits.

Negera M ，Abdisa D 《BMC HEALTH SERVICES RESEARCH》

Willingness of community based health insurance uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, a cross-sectional study.

Deksisa A ，Abdo M ，Mohamed E ，Tolesa D ，Garoma S ，Zewdie A ，Lami M ，Irena D ，Abdena D ，Lemi H ... -  《-》