Factors Associated with rural household heads length of years of stay in the community - based health insurance scheme of Lumu Kosa woreda, oromia, Ethiopia

Abstract

Background: The Government of Ethiopia uses the Community-Based Health Insurance (CBHI) program as a strategy to ensure Universal Health Coverage (UHC) for informal sector households. Objectives: This research aims to assess the factors associated with rural household heads' length of years of stay in the CBHI Scheme. Methods: The study used secondary data collected in the Jimma Zone of Limu Kossa Woreda from January to February 2020(1). The original research design was Community-based cross-sectional study design. A quantitative method was used and analysed by STATA version 17. A total of 399 sampled households were used for this study. Analysis was performed through descriptive statistics, principal component analysis, and negative binomial regression. Result: The average duration of the length of years of stay in the CBHI scheme was 2.6 years (± 2.4 SD). The findings of negative binomial regression showed that age, educational level, family size, future intention for renewal, involvement in the association, fourth wealth quintile, and sex were significant determinants of household head length of years of stay in CBHI Schemes. However, provider professional competence, illness experience, self-rated health Status, Awareness status, understanding of CBHI principles, and satisfaction with waiting time at the facility level were not significantly associated with the length of years of stay in the CBHI scheme. Conclusion and Recommendations: The average length of continuous renewal years was low. Our findings concluded that the strongest factor affecting the length of membership renewal at large is the socio-demographic factors. Accordingly, the evidence of adverse selection was present. Mandatory renewal, based on the differential premium, is essential. Improving the quality of public health care, especially the optimal availability of essential drugs at the facility level, is required. Key Word: Universal Health Coverage, CBHI, Length of years of stay in CBHIS, Adverse Selection