Health System Management

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Author: search.filters.author.YADASA MIRAStart date: 2023

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    COMMUNITY-BASED HEALTH INSURANCE MEMBERSHIP DROPOUT RATE AND ASSOCIATED FACTORS IN BORE WOREDA, GUJI ZONE, ETHIOPIA: MIXED STUDY DESIGN
    (hawassa universty, 2023-11) YADASA MIRA
    Background: The community-based health insurance program in Ethiopia was introduced in 2011, and 48% of homes were enrolled in June 2015. However, 18% of families that had subscribed in the first year stopped in the second year. While still initial enrollment is crucial, a higher dropout rate threatens the sustainability of community-based health insurance. This also has a negative effect on future enrollment and the magnitude of drop-out rates in addition to reducing the size of the insurance pool. However, there is a scarcity of data on household dropout rates of community-based health insurance coverage and related factors in Bore Woreda. Objective: Community-Based Health Insurance Membership Dropout Rate and Associated Factors in Bore Woreda, Guji Zone, Ethiopia, 2023. Method: Community-based cross-sectional study design supplemented by a qualitative method was employed. A total sample size of 502 for the quantitative study, and a purposive sampling for key informants interviewed from scheme officers, kebele managers, health office heads, and health center directors were included. We used a multistage sampling technique to select samples from the Kebeles. Data were entered into SPSS then descriptive analysis and binary logistic regressions were computed. Qualitative data was transcribed and manually analyzed using thematic area analysis. Result: The magnitude of the dropout from CBHIM was 21.1% with a 95% confidence interval (CI): of 17.5%-25.1%. Number of household family size, > six (6) (AOR:0.55, 95% CI: 0.33 - 0.93), annual family income > 25000 (AOR:2.11, 95% CI: 1.26,3.53), the place they usually seek treatment in, private health facility (AOR:0.15, 95% CI: 0.07,0.93) were found to be significantly associated dropout from community-based health insurance. The overall perception towards CBHIM was found to be favorable with 96.6% among the respondents. The theme identified from the qualitative study was “increasing number of new enrollments”, there are dropouts from the scheme. And also “socioeconomic factors like household income and household family size”. The “unavailability of drugs and other medical equipment” was a major complaint for dropping out of the scheme. Conclusion: The findings from the study showed that dropout is high in the area. Annual family income, household family size, and the place they usually seek treatment were found to be associated with dropout from community-based health insurance. The findings from qualitative also showed that there is a dropout of CBHIM in the community and also suggested that sociodemographic factors like income and family size have effects on membership. As a recommendation, we recommend emphasizing more on availing medications as well as other medical equipment and focusing on bettering health care service quality.