Willingness to contribute for Health Insurance scheme and its determinants among civil servants in Addis Ababa
Derseh, Anagaw(PhD); Tassew, Berhan (MPH)
Background: Ethiopia endorsed health care reforms to obtain resources, increase
efficiency and promoting sustainability of health care financing. One of the
components of the reform is to provide social health insurance for formal and
community based health insurance for informal sectors. In the long run, the
government plans to create strong risk pool and create equity in the health system by
merging SHI and CBHI schemes.
Objectives: To assess willingness to contribute for community-based health insurance
and factors affecting it among civil servants in Addis Ababa.
Methods: Institutional based Cross-sectional study was conducted in selected
governmental organization in Addis Ababa. Total of 487 respondents who were
selected using multi-stage sampling method were participated. The data was collected
using structured self-administered questioner then entered and analyzed with SPSS
version 21.0. A descriptive analysis was performed to describe the characteristics of
participants. Chi-square test was used to test association between selected
socio-demographic characteristics and awareness of health insurance scheme. Binary
and then multiple logistic regressions were used to know the final predictors of
willingness to contribute among the independent variables at P-value <0.05.
Result: Among 478 respondents, 115(24.1%) of them were willing to contribute for
CBHI scheme. Those who are willing contribute 240ETB (8.3$US) per annum. The
finding revealed that gender, educational status, trust in health insurance agency,
participation in traditional saving association and community solidarity significantly
determine willingness to contribute for CBHI. The main reason for not willing to
contribute for CBHI was found to be lack of enough income. From the study
participants only 22.8% (109) of had good awareness about health insurance schemes.
Conclusion: This study finds the share of civil servants who are willingness to
support CBHI scheme is low in Addis Ababa. Building trust on the scheme and
enhance social solidarity are found to be important factor to influence willingness to
for the scheme. Interventions to reduce poverty and expand educational coverage are
also important issues to be considered in order to make civil servant to contribute to
CBHI on volunteer basis.
Civil servants, willingness to contribute, social solidarity, Ethiopia
Addis Abeba University
Type of publication|
Addis Ababa - University of Addis Ababa
Added to C-A: 2021-01-06;10:51:00|
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