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The Role of Community Based Health Insurance Scheme on Financial Protection and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia

Received: 9 June 2018    Accepted: 4 July 2018    Published: 30 July 2018
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Abstract

Healthcare financing in many developing countries dominantly come from out-of-pocket expenditure, and it has remained problematic for its catastrophic consequences on the poor. Community based health insurance scheme become potential strategy to protect households from out- of –pocket expenditure and impoverishment, and access affordable and effective healthcare. Therefore, this study examined the role of community based health insurance on financial protection and healthcare seeking behavior of households in rural Ethiopia. Mixed research approach employed concurrently to collect data from participants, and collected data were analyzed through descriptive, inferential and thematic analysis. The study finding revealed that 71.5% of households protected from extra out of payments (other than premium payment for the scheme). Furthermore, large number of respondents (66.3%) replied that price for the scheme was easily affordable. Moreover, by avoiding out -of -pocket payment, community based health insurance improve healthcare seek behavior of households from modern healthcare providers. However, there were challenges in reimbursement, moral hazards or miss utilizations and adverse selections or the inclusion of chronically ill, poor and fee waivers during enrolment. In general, in the absence of third party and prepayment systems such as health insurance and tax-based healthcare financing, households in many low-income countries are exposed to the financial risks of paying large medical bills from out-of-pocket demands introduction of community based health insurance as alternative financial approach.

Published in International Journal of Health Economics and Policy (Volume 3, Issue 2)
DOI 10.11648/j.hep.20180302.11
Page(s) 13-19
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Community Based Health Insurance Scheme, Financial Protection, Mixed Research Approach, Healthcare Seeking Behavior, Ethiopia

References
[1] Jacobs, B., Maryam B., Maurits, P., Por, I., Cedric, S. and Bart C. Bridging community-based health insurance and social protection for health care – a step in the direction of universal coverage?. Tropical Medicine and International Health. Belgium. Blackwell Publishing Ltd; vol. 13 (2), 2008, pp. 140–143.
[2] Wolfe, R., McIntyre, D., Honda, A. and Hanson, K. Covering the informal sector: Report from a workshop on expanding access to health services and financial protection for people outside the formal employment sector. 2014.
[3] World Health Organization (WHO). The world health report: health systems financing: the path to universal coverage. Geneva; 2010: pp. 15-50.
[4] Federal Ministry of Health Ethiopia (FMoH). Health Sector Development Programme IV: 2010/11 – 2014/15'. Addis Ababa: The Federal Ministry of Health; 2010.
[5] CSA (Central Statistical Agency (Ethiopia)). Ethiopia Demographic and Health Survey. Addis Ababa: Ethiopia; 2014.
[6] Anagaw Derseh. Essays on evaluating a community based health insurance scheme in rural Ethiopia. International institute of social studies. Nezerlands. Netherlands Organization for Scientific Research; 2015.
[7] FMoH. Health Sector Strategic Plan—III2005/06–2009/10. Addis Ababa: Planning and Programming Department, Ministry of Health. 2005.
[8] MOFED. Summary of Consolidated Federal and Regional Budget, 2008/09. Addis Ababa: MOFED. 2008.
[9] Liu. Y. and Hsiao, W.. For the People, by the People: Community Financing of Healthcare in Developing Countries. Harvard Health Policy Review. Vol. 4 (2), 2003, pp. 102-111.
[10] Anagaw Derseh. Mebratie, Robert Sparrow, Zelalem Yilma, Getnet Alemu Arjun S. Bedi. Enrollment in Ethiopia’s Community-Based Health Insurance Scheme. World Development; 74, 2015, pp. 58–76.
[11] EHIA (Ethiopian Health Insurance Agency). Evaluation of Community-Based Health Insurance Pilot Schemes in Ethiopia: Final Report. Addis Ababa, Ethiopia; 2015.
[12] Dereje Wonde. and Getnet Tadele. Impedments of Health Seeking Behavior and Health Service Utilization from Healthcare Institutions in A Rural Community of Enebise Sar Mider Woreda, East Gojjam Zone, Ethiopia. Ethiop. J. Health. Dev. 29 (2), 2015, pp. 100-110.
[13] Fitsum Girma, Challi Jira and Belaineh Girma. Health Services Utilization and associated Factors in Jimma Zone, South West Ethiopia. Ethiop J Health Sci; vol. 21 (4): 2011, pp. 85-94.
[14] Hsiao, W. C. Unmet health needs of two billion: Is community financing a solution? HNP Discussion Paper. World Bank, Washington, DC. World Health Organization. Achieving universal health coverage: Developing the health financing system. Technical briefs for policy-makers, No (1), Geneva. 2001.
[15] WHO. Reporting on the Ethiopian World Health Survey 2003. Geneva: World Health Organization. 2005.
[16] USAID (United States of America International Development). Ethiopia Health Sector Financing Reform: Midterm Project Evaluation. Addis Ababa: The United States Agency for International Development; 2011.
[17] Tehuledere District Administration Document Office. General information about the study Area; 2017.
[18] Tehuledere District Community based health insurance Office Annual Report. Design and implementation of community based health insurance in the Study Area; 2016/17.
[19] Yamane, T.. Statistics: an introductory analysis. New York. Harper and Raw publication; 1967.
[20] WHO. Water, health and ecosystems. Available at: http://www. who.int/heli/risks/water/water/en/.2015.
[21] Wiesmann D. and Jutting, J. The Emerging Movement of Community Based Health Insurance in Sub-Saharan Africa: Experiences and Lessons Learned. Afrika spectrum vol. 35 (2) 2000.
[22] Jutting, J. P. 2003. Do community-based health care insurance schemes improve poor people’s access to health care? Evidence from rural Senegal. World Dev. 32, 2003. pp. 273-288.
[23] Msuya, J., Jutting, J. and Abay A. Impact of Community Health Funds on the Access to Health Care: Empirical Evidence from Rural Tanzania. International Journal of Public Administration, vol. 30 (8). 2007.
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  • APA Style

    Molla Yismaw Jembere. (2018). The Role of Community Based Health Insurance Scheme on Financial Protection and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia. International Journal of Health Economics and Policy, 3(2), 13-19. https://doi.org/10.11648/j.hep.20180302.11

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    ACS Style

    Molla Yismaw Jembere. The Role of Community Based Health Insurance Scheme on Financial Protection and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia. Int. J. Health Econ. Policy 2018, 3(2), 13-19. doi: 10.11648/j.hep.20180302.11

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    AMA Style

    Molla Yismaw Jembere. The Role of Community Based Health Insurance Scheme on Financial Protection and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia. Int J Health Econ Policy. 2018;3(2):13-19. doi: 10.11648/j.hep.20180302.11

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  • @article{10.11648/j.hep.20180302.11,
      author = {Molla Yismaw Jembere},
      title = {The Role of Community Based Health Insurance Scheme on Financial Protection and Healthcare Seeking Behavior of Households in Tehuledere District, Northeast Ethiopia},
      journal = {International Journal of Health Economics and Policy},
      volume = {3},
      number = {2},
      pages = {13-19},
      doi = {10.11648/j.hep.20180302.11},
      url = {https://doi.org/10.11648/j.hep.20180302.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.hep.20180302.11},
      abstract = {Healthcare financing in many developing countries dominantly come from out-of-pocket expenditure, and it has remained problematic for its catastrophic consequences on the poor. Community based health insurance scheme become potential strategy to protect households from out- of –pocket expenditure and impoverishment, and access affordable and effective healthcare. Therefore, this study examined the role of community based health insurance on financial protection and healthcare seeking behavior of households in rural Ethiopia. Mixed research approach employed concurrently to collect data from participants, and collected data were analyzed through descriptive, inferential and thematic analysis. The study finding revealed that 71.5% of households protected from extra out of payments (other than premium payment for the scheme). Furthermore, large number of respondents (66.3%) replied that price for the scheme was easily affordable. Moreover, by avoiding out -of -pocket payment, community based health insurance improve healthcare seek behavior of households from modern healthcare providers. However, there were challenges in reimbursement, moral hazards or miss utilizations and adverse selections or the inclusion of chronically ill, poor and fee waivers during enrolment. In general, in the absence of third party and prepayment systems such as health insurance and tax-based healthcare financing, households in many low-income countries are exposed to the financial risks of paying large medical bills from out-of-pocket demands introduction of community based health insurance as alternative financial approach.},
     year = {2018}
    }
    

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    AB  - Healthcare financing in many developing countries dominantly come from out-of-pocket expenditure, and it has remained problematic for its catastrophic consequences on the poor. Community based health insurance scheme become potential strategy to protect households from out- of –pocket expenditure and impoverishment, and access affordable and effective healthcare. Therefore, this study examined the role of community based health insurance on financial protection and healthcare seeking behavior of households in rural Ethiopia. Mixed research approach employed concurrently to collect data from participants, and collected data were analyzed through descriptive, inferential and thematic analysis. The study finding revealed that 71.5% of households protected from extra out of payments (other than premium payment for the scheme). Furthermore, large number of respondents (66.3%) replied that price for the scheme was easily affordable. Moreover, by avoiding out -of -pocket payment, community based health insurance improve healthcare seek behavior of households from modern healthcare providers. However, there were challenges in reimbursement, moral hazards or miss utilizations and adverse selections or the inclusion of chronically ill, poor and fee waivers during enrolment. In general, in the absence of third party and prepayment systems such as health insurance and tax-based healthcare financing, households in many low-income countries are exposed to the financial risks of paying large medical bills from out-of-pocket demands introduction of community based health insurance as alternative financial approach.
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Author Information
  • Department of Sociology, Wollo University, Desssie, Ethiopia

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