Department of Public Health, College of Medicine and Health Science, Debre Markos University, 269, Debre Markos, Ethiopia.
Department of Epidemiology and Biostatistics, School of Public Health, College of Medicine and Health Science, Bahir Dar University, 79, Bahir Dar, Ethiopia.
Glob Health Res Policy. 2023 Sep 15;8(1):41. doi: 10.1186/s41256-023-00325-y.
Community-based health insurance (CBHI) schemes are crucial for households to avoid financial hardship, improve healthcare quality, and engage in health policies. Household satisfaction is a key indicator for assessing healthcare quality and identifying service gaps. However, research on household satisfaction with CBHI in Ethiopia is limited. Therefore, this study aimed to evaluate household satisfaction and associated factors with CBHI schemes in Ethiopia.
A comprehensive search of relevant literature was conducted using multiple databases, including PubMed, Google Scholar, Africa Journal Online, and Ethiopian Universities' institutional open-access online repositories. The search was carried out between January 25, 2023, and February 28, 2023. Twelve primary studies, including eight published and four unpublished, were identified and included in the analysis with a total sample size of 5311 participants. A protocol with the registration number CRD20531345698 is recorded on the Prospero database. Two authors, DT and MK, independently extracted the required data using a standardized form. The extracted data were then analyzed using STATA version 17 software. Heterogeneity was assessed using the Cochrane Q-test and I tests. Finally, a random-effect model was employed to calculate the overall household satisfaction with CBHI and to determine the associated factors.
The meta-analysis showed that the overall household satisfaction with CBHI in Ethiopia was 62.26% (95% CI 53.25-71.21%). The study found regional variations in household satisfaction, with 63.40% in Oromia, 64.01% in Amhara, 49.58% in Addis Ababa, and 66.76% in SNNPs. The study identified several factors associated with household satisfaction and the CBHI scheme, including the availability of drugs (OR 2.13, 95% CI 1.47-2.78), friendly services (OR 3.85, 95% CI 1.60-6.10), affordability of premium (OR 2.80, 95% CI 1.97-3.63), and knowledge/awareness of CBHI (OR 2.52, 95% CI 1.73-3.33).
The study provides valuable insights into household satisfaction with CBHI in Ethiopia, with a considerable proportion of enrolees being satisfied. The finding highlights regional variations in household satisfaction and underscores the need for tailored interventions and monitoring to enhance CBHI sustainability and effectiveness. The results suggest that healthcare providers and policymakers should prioritize the availability of drugs, friendly services, affordable premiums, and education to improve household satisfaction with CBHI schemes.
社区健康保险（CBHI）计划对于家庭避免经济困难、提高医疗质量和参与卫生政策至关重要。家庭满意度是评估医疗质量和识别服务差距的关键指标。然而，埃塞俄比亚社区健康保险计划的家庭满意度研究有限。因此，本研究旨在评估埃塞俄比亚家庭对 CBHI 计划的满意度及其相关因素。
使用多个数据库（包括 PubMed、Google Scholar、Africa Journal Online 和埃塞俄比亚大学机构开放获取在线资源库）进行了全面的文献检索。检索时间为 2023 年 1 月 25 日至 2 月 28 日。确定了 12 项初级研究，包括 8 项已发表的研究和 4 项未发表的研究，共纳入 5311 名参与者进行分析。已在 Prospero 数据库中记录了注册号 CRD20531345698。两位作者 DT 和 MK 使用标准化表格独立提取所需数据。使用 STATA 版本 17 软件分析提取的数据。使用 Cochrane Q 检验和 I 检验评估异质性。最后，使用随机效应模型计算 CBHI 的总体家庭满意度，并确定相关因素。
荟萃分析显示，埃塞俄比亚家庭对 CBHI 的总体满意度为 62.26%（95%CI 53.25-71.21%）。研究发现家庭满意度存在区域差异，奥罗莫地区为 63.40%，阿姆哈拉地区为 64.01%，亚的斯亚贝巴为 49.58%，南部民族、人民和地区州为 66.76%。研究确定了与家庭满意度和 CBHI 计划相关的几个因素，包括药物供应（OR 2.13，95%CI 1.47-2.78）、服务友好性（OR 3.85，95%CI 1.60-6.10）、保费负担能力（OR 2.80，95%CI 1.97-3.63）和对 CBHI 的了解/意识（OR 2.52，95%CI 1.73-3.33）。
本研究提供了埃塞俄比亚家庭对 CBHI 满意度的有价值见解，相当一部分参保人表示满意。研究结果突显了家庭满意度的区域差异，强调需要采取有针对性的干预措施和监测，以提高 CBHI 的可持续性和效果。结果表明，医疗保健提供者和政策制定者应优先考虑药物供应、友好服务、负担得起的保费和教育，以提高家庭对 CBHI 计划的满意度。
