Department of Statistics, Debre Tabor University, Debre Tabor, Ethiopia.
PLoS One. 2022 Oct 10;17(10):e0275896. doi: 10.1371/journal.pone.0275896. eCollection 2022.
Community-based health insurance (CBHI) is a type of volunteer health insurance that has been adopted all over the world in which people of the community pool funds to protect themselves from the high costs of seeking medical care and treatment for the disease. In Ethiopia, healthcare services are underutilized due to a lack of resources in the healthcare system. The study aims to identify the individual and community level factors associated with community-based health insurance enrollment of households in Ethiopia.
Data from the Ethiopian mini demographic and health survey 2019 were used to identify factors associated with community-based health insurance enrollment of households in Ethiopia. Multilevel logistic regression analysis was used on a nationally representative sample of 8,663 households nested within 305 communities, considering the data's layered structure. We used a p-value<0.05 with a 95% confidence interval for the results.
The prevalence of community-based health insurance enrollment in Ethiopia was 20.2%. The enrollment rate of households in the scheme was high in both Amhara (57.9), and Tigray (57.9%) regions and low (3.0%) in the Afar region. At the individual level; the age of household heads, number of children 5 and under, number of household members, has land for agriculture, has a mobile telephone, receiving cash of food from the safety Net Program, Owning livestock, and herds of farm animals, wealth index, and at the community level; the region had a significant association with community-based health insurance enrollment.
Both individual and community-level characteristics were significant predictors of community-based health insurance enrollment in households. Furthermore, the ministry of health, health bureaus, and other concerning bodies prioritize clusters with low health insurance coverage to strengthen health system financing and intervene in factors that negatively affect the CBHI enrollment of households.
社区健康保险（CBHI）是一种志愿健康保险，已在全球范围内采用，社区内的人们将资金汇集在一起，以防止因寻求医疗服务和治疗疾病而产生高昂的费用。在埃塞俄比亚，由于医疗体系缺乏资源，医疗服务的利用率较低。本研究旨在确定与埃塞俄比亚家庭参与社区健康保险相关的个人和社区层面的因素。
使用 2019 年埃塞俄比亚微型人口和健康调查的数据，确定与埃塞俄比亚家庭参与社区健康保险相关的因素。对 305 个社区内嵌套的 8663 户家庭进行了全国代表性样本的多水平逻辑回归分析，考虑到数据的分层结构。我们使用具有 95%置信区间的 p 值<0.05 来表示结果。
埃塞俄比亚社区健康保险的参保率为 20.2%。该计划在阿姆哈拉（57.9%）和提格雷（57.9%）地区的家庭参保率较高，而在阿法尔地区的参保率较低（3.0%）。在个人层面上；家庭户主的年龄、5 岁以下的儿童人数、家庭人数、拥有农业用地、拥有移动电话、从安全网计划中获得现金粮食、拥有牲畜和农场动物、财富指数，以及在社区层面上；地区与社区健康保险的参保率显著相关。
个人和社区层面的特征都是家庭参与社区健康保险的重要预测因素。此外，卫生部、卫生局和其他有关机构应优先考虑参保率较低的群体，以加强卫生系统筹资，并干预对家庭 CBHI 参保率有负面影响的因素。
