Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study
BackgroundDespite the fact that community-based health insurance (CBHI) is a promising program to achieve the goal of universal health coverage (UHC), it faces challenges that are not only due to low enrollment but also due to membership renewal decision that impact its sustainability. Hence, the st...
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Frontiers Media S.A.
2024-01-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192991/full |
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| author | Edosa Tesfaye Geta Edosa Tesfaye Geta Kifile Abdisa Lushe Adisu Ewunetu Desisa Dufera Rikitu Terefa Melese Chego Cheme Adisu Tafari Shama Matiyos Lema |
| author_facet | Edosa Tesfaye Geta Edosa Tesfaye Geta Kifile Abdisa Lushe Adisu Ewunetu Desisa Dufera Rikitu Terefa Melese Chego Cheme Adisu Tafari Shama Matiyos Lema |
| author_sort | Edosa Tesfaye Geta |
| collection | DOAJ |
| description | BackgroundDespite the fact that community-based health insurance (CBHI) is a promising program to achieve the goal of universal health coverage (UHC), it faces challenges that are not only due to low enrollment but also due to membership renewal decision that impact its sustainability. Hence, the study aimed to identify the determinants of CBHI membership renewal decision among rural households in Kellem Wollega zone, Ethiopia.MethodsThe study was conducted in Kellem Wollega, Ethiopia, among rural households from March 30–April 30, 2022, using a community-based cross-sectional study design. An interviewer-administered structured questionnaire through face-to-face interviews was used. Using a systematic random sampling method, 551 households were selected making 540 (98%) response rates. The data was entered into EPI Data 3.1 and analyzed using SPSS 25 software. Descriptive statistics, binary, and multiple logistic regressions were performed. Using multiple logistic regressions, a significant association between the CBHI membership renewal decision and independent variables was identified, declaring the statistical significance level using a 95% confidence interval (CI) at p < 0.05.ResultsThe overall rate of CBHI membership renewal decision among households was estimated to be 365 (67.6%, 95% CI = 63.7–71.5%). The factors that significantly influenced the households’ membership renewal decision were family size (AOR = 0.46, 95% CI = 0.25–0.86), low literacy status (AOR = 0.28 95% CI = 0.12–0.64), lower than middle-level of wealth index (AOR = 9.80, 95% CI = 2.75–34.92), premium affordability (AOR = 4.34, 95% CI = 2.08–9.04), unavailability of services (AOR = 0.26, 95% CI = 0.12–0.55), trusting in health facilities (AOR = 5.81, 95% CI = 2.82–11.94), favorable providers’ attitude toward members (AOR = 8.23, 95% CI = 3.96–19.64), good quality of service (AOR = 4.47, 95% CI = 2.28–8.85) and health care seeking behavior (AOR =3.25, 95% CI = 1.32–7.98).ConclusionThe overall CBHI membership dropout decision rate among rural households was high, which could affect health service provision and utilization. Therefore, the insurance scheme and contracted health facilities should consider and work on family size and wealth status when membership premiums are calculated, the education level of households when creating awareness about the scheme, building trust in the contracted health facilities by providing all promised benefit packages of health services with good quality, and improving the attitude of health care providers towards the scheme members. |
| first_indexed | 2024-03-08T17:08:24Z |
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| id | doaj.art-cc44f64c585546e19b2b2b5e95abba07 |
| institution | Directory Open Access Journal |
| issn | 2296-2565 |
| language | English |
| last_indexed | 2024-03-08T17:08:24Z |
| publishDate | 2024-01-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Public Health |
| spelling | doaj.art-cc44f64c585546e19b2b2b5e95abba072024-01-04T04:15:25ZengFrontiers Media S.A.Frontiers in Public Health2296-25652024-01-011110.3389/fpubh.2023.11929911192991Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional studyEdosa Tesfaye Geta0Edosa Tesfaye Geta1Kifile Abdisa Lushe2Adisu Ewunetu Desisa3Dufera Rikitu Terefa4Melese Chego Cheme5Adisu Tafari Shama6Matiyos Lema7Kellem Wollega Zonal Health Department, Dembi Dollo, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaKellem Wollega Zonal Health Department, Dembi Dollo, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaDepartment of Public Health, Institute of Health Science, Wollega University, Nekemte, EthiopiaBackgroundDespite the fact that community-based health insurance (CBHI) is a promising program to achieve the goal of universal health coverage (UHC), it faces challenges that are not only due to low enrollment but also due to membership renewal decision that impact its sustainability. Hence, the study aimed to identify the determinants of CBHI membership renewal decision among rural households in Kellem Wollega zone, Ethiopia.MethodsThe study was conducted in Kellem Wollega, Ethiopia, among rural households from March 30–April 30, 2022, using a community-based cross-sectional study design. An interviewer-administered structured questionnaire through face-to-face interviews was used. Using a systematic random sampling method, 551 households were selected making 540 (98%) response rates. The data was entered into EPI Data 3.1 and analyzed using SPSS 25 software. Descriptive statistics, binary, and multiple logistic regressions were performed. Using multiple logistic regressions, a significant association between the CBHI membership renewal decision and independent variables was identified, declaring the statistical significance level using a 95% confidence interval (CI) at p < 0.05.ResultsThe overall rate of CBHI membership renewal decision among households was estimated to be 365 (67.6%, 95% CI = 63.7–71.5%). The factors that significantly influenced the households’ membership renewal decision were family size (AOR = 0.46, 95% CI = 0.25–0.86), low literacy status (AOR = 0.28 95% CI = 0.12–0.64), lower than middle-level of wealth index (AOR = 9.80, 95% CI = 2.75–34.92), premium affordability (AOR = 4.34, 95% CI = 2.08–9.04), unavailability of services (AOR = 0.26, 95% CI = 0.12–0.55), trusting in health facilities (AOR = 5.81, 95% CI = 2.82–11.94), favorable providers’ attitude toward members (AOR = 8.23, 95% CI = 3.96–19.64), good quality of service (AOR = 4.47, 95% CI = 2.28–8.85) and health care seeking behavior (AOR =3.25, 95% CI = 1.32–7.98).ConclusionThe overall CBHI membership dropout decision rate among rural households was high, which could affect health service provision and utilization. Therefore, the insurance scheme and contracted health facilities should consider and work on family size and wealth status when membership premiums are calculated, the education level of households when creating awareness about the scheme, building trust in the contracted health facilities by providing all promised benefit packages of health services with good quality, and improving the attitude of health care providers towards the scheme members.https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192991/fullCBHI schememembership renewal decisionrural householdsKellem WollegaEthiopia |
| spellingShingle | Edosa Tesfaye Geta Edosa Tesfaye Geta Kifile Abdisa Lushe Adisu Ewunetu Desisa Dufera Rikitu Terefa Melese Chego Cheme Adisu Tafari Shama Matiyos Lema Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study Frontiers in Public Health CBHI scheme membership renewal decision rural households Kellem Wollega Ethiopia |
| title | Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study |
| title_full | Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study |
| title_fullStr | Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study |
| title_full_unstemmed | Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study |
| title_short | Determinants of community-based health insurance membership renewal decision among rural households in Kellem Wollega zone, Oromia regional state, Ethiopia: a community-based cross-sectional study |
| title_sort | determinants of community based health insurance membership renewal decision among rural households in kellem wollega zone oromia regional state ethiopia a community based cross sectional study |
| topic | CBHI scheme membership renewal decision rural households Kellem Wollega Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2023.1192991/full |
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