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Background: Many households in low and middle income countries face financial catastrophe and impoverishing effects of paying for health services out-of-pocket. There is increasing advocacy for community-based health insurance schemes as part of a broader solution to health care financing problems in low-income countries, but up to date there were very limited uptake of CBHI scheme Objective: To asses factors affecting up-take of community based health insurance scheme Methods: Both qualitative and quantitative study designs were used. For the quantitative method, cross- sectional study was conducted in December 2016, to assess factors affecting uptake of CBHI in Sabata Hawas Woreda. To support quantitative study, qualitative study was conducted using three focus group discussions. Quantitative data was entered in to EPI info then exported to SPSS for cleaning and analyzing while qualitative data were transcribed and translated into English and then manipulated manually by grouping the ideas into similar thematic sets. Results: Among 630 study participants who were interviewed, 503(79.8%) were male. This study revealed that uptake of CBHI scheme among HH heads whose their annual income <40,000 birr/year were less likely than those whose their income > 40,000 birr/year, OR=0.562; 95% CI (0.371, 0.850).Uptake of CBHI among respondents whose their family size <5 were less likely than those who have >5 family, AOR =0.404; 95% CI (0.271, 0.603). Uptake of CBHI among study participants who have no awareness about CBHI less likely than who have awareness, AOR =0.148; 95% CI (0.039, 0.565).Uptake of CBHI among study participants who were not experienced illness in the last six months during the study period were less likely than who fallen , AOR=0.606; 95 % CI (0.406, 0.904).Uptake of CBHI among respondents who thought payment of premium is to finance future health care needs were more likely than who were not, OR=2.046 ;95% CI (1.256, 3.334).Uptake of CBHI among respondents who didn’t know whether CBHI is like saving scheme will receive interest and get money back were less likely than who knew as if interests and money paid couldn’t get back in cash, OR=0.374 ;95% CI (0.171, 0.816).Uptake of CBHI among respondents who trust their local CBHI management were more likely than those who didn’t know whether trustful or not, AOR= 2.006(1.301, 3.091) Conclusion and recommendations: From this study it was concluded that, family size, annual income, awareness about CBHI, illness experience and perception towards payment of premium is to finance future health care needs, CBHI is like saving scheme receive interest and get money back and trust on local CBHI management were factors which influences uptake of CBHI. Many efforts needed to improve availability of drug and prolonged waiting time to get health services as well as on awareness creation and on concepts of the features of CBHI so as to familiarize the community with the scheme. |
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