| dc.description.abstract |
Background: Community Based Health Insurance scheme was initiated and employed among 13 selected Woredas of Tigray, Amhara, Oromia, and South Nations, Nationalities & peoples regions in Ethiopia. However, small amount of population was observed to be enrolled, among them majority of them did not renew their memberships.
Objectives: This study was aimed to identify factors of community based health insurance membership renewal in South Achefer woreda, West Gojjam, Ethiopia.
Methods: A case control study used both quantitative & qualitative was conducted from April 2016 to December 2016 at West Gojjam, Ethiopia. The study participants of the quantitative were 336 (168 cases and 168 controls). A pretested questionnaire was used to collect the required data. The data were entered using the Epi-Info version 3.5.1 software and analyzed using SPSS version 16 software. Qualitative data were collected to examine in more depth on constraints to the outcome variable using focus group discussions. The data were then transcribed and translated into English. Open code version 3.6 was used for analysis. Descriptive statistics, bi-variate, and multi-variate logistic regression analyses were used to describe the study objectives and assess risk factors of community based health insurance membership renewal. Odds ratio at 95% CI was used to describe the association between the study and the outcome variables.
Results: Education (AOR = 1.46, 95% CI [1.22, 1.75]), estimated monthly income (AOR = 2.32, 95% CI [1.77, 2.54]), family size (AOR = 0.40, 95% CI [0.21, 0.61]), participation in the program (AOR = 1.5, 95% CI [1.04, 1.78]) and membership payment affordability ((AOR = 2.01, 95% CI [1.43, 2.82])) were found to be barriers for the program membership renewal. Thus variables educational status, estimated monthly income, number of dependent family members, participation on the programs and affordability had significant associations with Community Based Health Insurance membership renewal.
Conclusion and Recommendations: This study had revealed important barriers for Community Based Health Insurance membership renewal. There were combinations of demand and supply side factors constraining constant membership renewal. Community Based Health Insurance program should consider these important factors and build mechanisms to attract members from their membership exit. Quality of service delivered should be improved at health facilities for those who are members of the program.
....................................... Thesis available at ACIPH Library |
|