Assessment of uptake and factors influencing enrolment of community based health insurance in south Achefer district, North west Ethiopia

Abstract

Background: Inability to pay the out-of-pocket (OOP) expenditure required to access health services -has been taught as one of the main impediments to access healthcare particularly for the poor and the vulnerable. One way to facilitate access and overcome catastrophic expenditure is through a community-based health insurance (CBHI) scheme whereby risks are shared and financial inputs pooled by way of contributions. Among the problems encountered by health insurance systems, the - question of enrolment appears as a central element. The problem assumes acute proportions in sub­ Saharan Africa, where schemes rarely attain 10% coverage among target populations. Objective: To assess uptake and factors influencing enrolment of community based health insurance ~in south Achefer district, North West Ethiopia. Method: A community based cross-sectional study design employing both quantitative &qualitative method of data collection will be conducted on uptake and factors influencing enrolment of community based health insurance in South Achefer district. Six hundred thirty four Participants will be selected by stratified multi stage systematic random sampling procedure. The data will be collected by pretested interviewer administered questionnaire and focus group discussion. The data collection will be carried out by six enumerators who at least have diploma and two supervisors who have degree holder. Data will be entered using EPI INFO version 3.5.3 and analyzed by SPSS version 20.0. Bivariate and multivariate logistic regressions will be used in order to identify predictive variables and Odds ratio (OR) with 95% confidence interval and p-value <0.05 will be used a measure of association. Ethical approval will be obtained from ethical review committee of college of medicine and health science Bahir, Dar University. Verbal consents will be also taken from participants. Work plan and Budget: The study will be conducted from June to September 2014 and it will require ~ 27,632ETB to be accomplished.