scholarly journals Factors Contributing to Low Adherence to Community-Based Health Insurance in Rural Nyanza District, Southern Rwanda

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Mecthilde Mukangendo ◽  
Manasse Nzayirambaho ◽  
Regis Hitimana ◽  
Assumpta Yamuragiye
Keyword(s):  
Health Insurance ◽  
Medical Care ◽  
Waiting Time ◽  
Care Provider ◽  
Care Service ◽  
Health Care Service ◽  
Community Based ◽  
Cross Sectional ◽  
Premium Payment ◽  
Community Based Health Insurance

Background. Community-based health insurance (CBHI) schemes are an emerging mechanism for providing financial protection against health-related poverty. In Rwanda, CBHI is being implemented across the country, and it is based on four socioeconomic categories of the “Ubudehe system”: the premiums of the first category are fully subsidized by government, the second and third category members pay 3000 frw, and the fourth category members pay 7000 frw as premium. However, low adherence of community to the scheme since 2011 has not been sufficiently studied. Objective. This study aimed at determining the factors contributing to low adherence to the CBHI in rural Nyanza district, southern Rwanda. Methodology. A cross-sectional study was conducted in nine health centers in rural Nyanza district from May 2017 to June 2017. A sample size of 495 outpatients enrolled in CBHI or not enrolled in the CBHI scheme was calculated based on 5% margin of error and a 95% confidence interval. Logistic regression was used to identify the determinants of low adherence to CBHI. Results. The study revealed that there was a significant association between long waiting time to be seen by a medical care provider and between health care service provision and low adherence to the CBHI scheme (P value < 0.019) (CI: 0.09107 to 0.80323). The estimates showed that premium not affordable (P value < 0.050) (CI: 0.94119 to 9.8788) and inconvenient model of premium payment (P value < 0.001) (CI: 0.16814 to 0.59828) are significantly associated with low adherence to the CBHI scheme. There was evidence that the socioeconomic status as measured by the category of Ubudehe (P value < 0.005) (CI: 1.4685 to 8.93406) increases low adherence to the CBHI scheme. Conclusion. This study concludes that belonging to the second category of the Ubudehe system, long waiting time to be seen by a medical care provider and between services, premium not affordable, and inconvenient model of premium payment were significant predictors of low adherence to CBHI scheme.

scholarly journals Client satisfaction on community based health insurance scheme and associated factors at Boru Meda Hospital, Northeast, Ethiopia: institutional based cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mulugeta Tasew Hailie ◽  
Seid Legesse Hassen ◽  
Minwuyelet Maru Temesgen
Keyword(s):  
Health Insurance ◽  
Waiting Time ◽  
Client Satisfaction ◽  
Service Providers ◽  
Cross Sectional Study ◽  
Insurance Scheme ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Study Participants

Abstract Background Community-based health insurance systems are usually voluntary and characterized by community members pooling funds and protecting themselves against the high costs of seeking medical care and treatment for illness. Client satisfaction with health service provision during the implementation of health insurance schemes has often been neglected. This study aimed to determine client satisfaction with the community-based health insurance scheme and associated factors. Methods An institutional-based cross-sectional study design was applied from February 22–March 11 /2019. A total of 420 study participants were included in the study using a systematic random sampling technique. Data were collected using a pretested semi-structured interviewer-administered questionnaire with a patient exit interview. Bivariate and multivariate logistic regression analyses were used to identify factors associated with Community-based Health Insurance of client satisfaction. Statistical significance was decided at a p-value less than 0.05. Result A total of 420 community-based health insurance clients of health service users participated in the study with a 100% response rate. The overall client satisfaction was 80% at 95% Cl (76.1, 83.9), respondents who have perceived that partially or none availability of prescribing drugs were 0.09 times less likely satisfied as compared to full availability of prescribing drugs (AOR =0.09; 95% Cl: (0.04, 0.19)). Besides, study participants waiting time to consult service providers within 30 min were more satisfied than those who were delayed 60 min and above (AOR =3.16; 95% Cl: (1.19, 8.41)). Conclusion Community-based health insurance client satisfaction provided in the present study was 80% indicating low proportion. Full availability of prescribing drugs, clients renewed their community-based health insurance membership, and preference of clients to use the hospital for future health care need were positively associated with client satisfaction while the perception of waiting time before physician consultation negatively affected client’s satisfaction. Therefore, the hospital management members and service providers need to give attention to reduce waiting time preceding consultation, improve drug availability, and sustain the hospital preference by the client.

scholarly journals Willingness of community based health insurance uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, a cross-sectional study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Alem Deksisa ◽  
Meyrema Abdo ◽  
Ebrahim Mohamed ◽  
Daniel Tolesa ◽  
Sileshi Garoma ◽  
...  
Keyword(s):  
Health Insurance ◽  
Willingness To Pay ◽  
Associated Factors ◽  
Cross Sectional Study ◽  
Urban Residents ◽  
Sectional Study ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Regional State

Abstract Background Globally, Millions of people cannot use health services because of the fear of payment for the service at the time of service delivery. From the agenda of transformation and the current situation of urbanization as well as to ensure universal health coverage implementing this program to the urban resident is mandatory. The aim of this study is to assess the willingness of community-based health insurance (CBHI) uptake and associated factors among urban residents of Oromia regional state, Oromia, Ethiopia, 2018. Methods A community-based cross-sectional study was conducted. From the total of eighteen towns; six towns which account for 33% of the total were selected randomly for the study. One population proportion formula was employed to get a total of 845 households. A pre-tested, semi-structured interviewer-administered questionnaire was used to collect the required data. Double-Bounded Dichotomous Choice Variant of the contingent valuation method was used to assess the maximum willingness to pay for the scheme, and a multiple logistic regression model was used to determine the effect of various factors on the willingness to join and willingness to pay for the households. Result About 839 (99.3%) of the respondents participated. The mean ages of the respondents were 40.44(SD ± 11.12) years. 621 (74.1%) ever heard about CBHI with 473 (56.3%) knowing the benefits package. Out of 839, 724 (86.3%) were willing to uptake CBHI of which 704 (83.9%) were willing to pay if CBHI established in their town. Conclusion If CBHI established about 86.3% of the households would enroll in the scheme. Having education, with a family size between 3 & 6, having difficulty in paying for health care and less than 20mins it took to reach the nearest health facility were the independent predictors of the willingness of CBHI uptake. The Oromia and Towns Health Bureau should consider the availability of health facilities near to the community and establishing CBHI in the urban towns.

The Impact of Community Based Health Insurance in Enhancing Better Accessibility and Lowering the Chance of Having Financial Catastrophe Due to Health Service Utilization

2015 ◽  
Vol 47 (3) ◽  
pp. 504-518 ◽  
Author(s):  
Somdeth Bodhisane ◽  
Sathirakorn Pongpanich
Keyword(s):  
Health Care ◽  
Health Insurance ◽  
Household Income ◽  
Health Care Services ◽  
Lower Probability ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Care Services ◽  
The Impact

The Lao population mostly relies on out-of-pocket expenditures for health care services. This study aims to determine the role of community-based health insurance in making health care services accessible and in preventing financial catastrophe resulting from personal payment for inpatient services. A cross-sectional study design was applied. Data collection involved 126 insured and 126 uninsured households in identical study sites. Two logistic regression models were used to predict and compare the probability of hospitalization and financial catastrophe that occurred in both insured and uninsured households within the previous year. The findings show that insurance status does not significantly improve accessibility and financial protection against catastrophic expenditure. The reason is relatively simple, as catastrophic health expenditure refers to a total out-of-pocket payment equal to or more than 40% of household income minus subsistence. When household income declines as a result of inability to work due to illness, the 40% threshold is quickly reached. Despite this, results suggest that insured households are not significantly better off under community-based health insurance. However, compared to uninsured households, insured households do have better accessibility and a lower probability of reaching the financial catastrophe threshold.

Determinants Perception and Experiences of Beneficiaries of a Hospital-based Community Health Insurance in Coastal Karnataka in India

2017 ◽  
Vol 19 (2) ◽  
pp. 244-254 ◽  
Author(s):  
Bhageerathy Reshmi ◽  
Sreekumaran Nair ◽  
Bhaskaran Unnikrishnan
Keyword(s):  
Health Insurance ◽  
Risk Sharing ◽  
Group Discussion ◽  
Health Care Financing ◽  
Preventive Treatment ◽  
Household Survey ◽  
Community Based ◽  
Cross Sectional ◽  
Community Based Health Insurance ◽  
Study Results

The objective of this study was to find out the perceptions of beneficiaries in comparison to non-beneficiaries of a community-based health insurance scheme. Both quantitative and qualitative methods were used to carry out this study; a cross-sectional household survey on 1,639 households was carried out, where the respondents were required to rate the services and facilities of the scheme A focus group discussion (FGD) with both the beneficiaries and non-beneficiaries was also carried out. Overall, the services were rated good except in the case of treatment and inpatient services where the responses were rated average. The study results provide evidence that Community Based Health Insurance (CBHI) schemes can be a viable risk sharing mechanism for the informal sector people who would have otherwise not been covered under any health insurance or health care financing mechanism. Maintaining an affordable premium and including outpatient facilities and preventive treatment would improve the satisfaction level of those who have acceptability towards CBHI schemes.

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