Girma Sintayehu, Abebe Gizachew, Tamire Aklilu, Fekredin Hamdi, Taye Bedasa
Fred Hollows Foundation, Addis Ababa, Ethiopia.
Gutazer Health Center, Gurage Zone, South Nation Nationalities and People, Walkite, Ethiopia.
Clinicoecon Outcomes Res. 2023 Mar 9;15:181-193. doi: 10.2147/CEOR.S397766. eCollection 2023.
Most developing nations lag behind in maintaining their populations' health. These nations are characterized by under-financing, low health cost protection mechanisms for the poor, and lack of risk pooling and cost sharing methods. To tackle this challenge, Ethiopia proposed social health insurance in 2010 even though its implementation was delayed. Hence, the purpose of this study was to assess teachers' willingness to pay for the newly proposed social health insurance and its associated factors.
A cross-sectional study was conducted and a stratified sampling technique was used to select government and private schools. After data were collected using a semi-structured self-administered questionnaire, binary and multivariate logistic regressions were done to examine determinants of willingness to pay for social health insurance.
Among participants who faced illness six months prior to the study, 85.7% reported that they paid "out of their pocket". About 59.2% and 54% of the teachers had a positive attitude and good knowledge toward health insurance schemes respectively. Of the total study respondents, 89.5% were willing to pay for the suggested insurance scheme. Forty eight percent of participants agreed to pay greater than or equal to 4% of their monthly salary. Willingness to pay was more likely among those who taught in secondary schools, had a positive attitude and good knowledge.
Nearly three fourths of the teachers showed willingness to pay for social health insurance. Participants with good knowledge, a positive attitude and from primary schools were more likely to be willing to pay for social health insurance. Equipping all public facilities' employees with necessary knowledge of social health insurance is essential to reduce catastrophic health care costs. Future researchers need to consider qualitative studies to support these findings.
大多数发展中国家在保障民众健康方面滞后。这些国家的特点是资金不足、针对贫困人口的医疗费用保护机制薄弱，且缺乏风险分担和费用分摊方法。为应对这一挑战，埃塞俄比亚在2010年提出了社会医疗保险，尽管其实施有所延迟。因此，本研究的目的是评估教师为新提议的社会医疗保险付费的意愿及其相关因素。
进行了一项横断面研究，并采用分层抽样技术选取政府和私立学校。使用半结构化自填问卷收集数据后，进行二元和多元逻辑回归分析，以检验社会医疗保险付费意愿的决定因素。
在研究前六个月患病的参与者中，85.7%报告称他们是“自掏腰包”支付费用。分别约有59.2%和54%的教师对医疗保险计划持积极态度且了解程度良好。在所有研究受访者中，89.5%愿意为提议的保险计划付费。48%的参与者同意支付其月工资的4%及以上。在中学任教、态度积极且了解程度良好的教师中，付费意愿更高。
近四分之三的教师表示愿意为社会医疗保险付费。知识丰富、态度积极且来自小学的参与者更有可能愿意为社会医疗保险付费。让所有公共机构的员工掌握社会医疗保险的必要知识对于降低灾难性医疗费用至关重要。未来的研究人员需要考虑进行定性研究以支持这些发现。
