Oromia regional health bureau, Addis Abeba, Ethiopia.
Department of Food Technology and Nutrition, Wollega University, P.O. Box 395, Nekemte, Ethiopia.
J Health Popul Nutr. 2024 May 20;43(1):71. doi: 10.1186/s41043-024-00553-z.
Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia.
A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value < 0.05 was considered the cut-off point for declaring a significant.
Among 422 study participants, 320 (75.83%) [95% CI = 71.5-79.8%)] of the households were willing to join community-based health insurance program. The willingness to join for community-based health insurance was 3.11 times more likely among households who were in the richest quintile (AOR = 3.11; 95% CI = 1.08-8.93), 3.4 times more likely among those who were merchants (AOR = 3.40;1.33, 8.69), 2.52 times more likely among those who had history of chronic illness in the household (AOR = 2.52; 95% CI = 1.43-4.45), 4.09 times more likely among those who had the awareness about the scheme (AOR = 4.09; 95% CI = 1.97-8.47) and 3.29 times more likely among those who had the experience of borrow for medical care (AOR = 3.29; 95% CI = 1.48-7.30).
Nearly three fourth of the households were willing to join community-based health insurance program, however, about one fourth of households were not willing, which is a significant public health problem. Being merchant, having awareness about the scheme, being in the richest wealth quintile, having experience of borrowing for medical care, and having history of chronic illness in the household were factors found to be significantly associated with willingness to join community based health insurance in the study area. Therefore, strengthening awareness creation at community level about the benefit package and principle of the program would increase their demand for the community-based health insurance scheme.
自 2011 年以来，埃塞俄比亚一直在实施社区医疗保险计划，以改善医疗保健融资体系。然而，城市地区对家庭参加社区医疗保险（CBHI）计划的意愿的流行程度及其相关因素的研究较少。因此，本研究旨在评估内克姆特市埃塞俄比亚家庭参加社区医疗保险计划的意愿及其相关因素的流行程度。
在内克姆特市，埃塞俄比亚进行了一项基于社区的横断面研究，共随机选择了 422 户家庭。使用二元逻辑回归模型对自变量和因变量之间的关系进行了双变量和多变量分析。使用调整后的优势比（AOR）和 95%置信区间（CI）描述关联。最后，p 值<0.05 被认为是宣布具有显著意义的截止点。
在 422 名研究参与者中，有 320 户（75.83%）[95%CI=71.5-79.8%]的家庭愿意参加社区医疗保险计划。最富有五分之一的家庭参加社区医疗保险的意愿是 3.11 倍（AOR=3.11；95%CI=1.08-8.93），是商人的家庭的 3.4 倍（AOR=3.40；1.33,8.69），是家中有慢性病史的家庭的 2.52 倍（AOR=2.52；95%CI=1.43-4.45），是有该计划意识的家庭的 4.09 倍（AOR=4.09；95%CI=1.97-8.47），是有医疗借贷经验的家庭的 3.29 倍（AOR=3.29；95%CI=1.48-7.30）。
近四分之三的家庭愿意参加社区医疗保险计划，但仍有四分之一的家庭不愿意参加，这是一个重大的公共卫生问题。作为商人、对该计划有认识、处于最富裕的五分之一、有医疗借贷经验和家庭有慢性病史的人，是与研究地区参加社区医疗保险意愿显著相关的因素。因此，在社区层面加强对该计划的利益和原则的认识，将提高他们对社区医疗保险计划的需求。
