Willingness to pay for community-based health insurance and associated factors among rural households of Bugna District, Northeast Ethiopia

Abstract Objective Community based health insurance schemes are becoming recognized as powerful method to achieve universal health coverage and reducing the financial catastrophic shock of the community. Therefore, this study aimed to assess willingness to pay for community-based health insurance and associated factors among rural households of Bugna District, Ethiopia. Results A total of 532 study participants were included in the study. The finding indicated that 77.8% of the households were willing to pay for the community-based health insurance. The average amount of money the households were willing to pay per household per annum was 233 ETB ($11.12 USD). The result of the study also revealed that attending formal education[ß = 3.20; 95% CI = 1.87, 4.53], history of illness [ß = 2.52; 95% CI = 1.29, 3.75], household size [ß = 0.408; 95% CI = 0.092, 0.724], awareness about the scheme [ß = 2.96; 95% CI = 1.61, 4.30], and wealth status [ß = 5.55; 95% CI = 4.19, 6.90] were factors significantly associated with willingness to pay. Therefore, enhancing awareness of the community about the scheme, considering the amount of premium as per household family size and wealth status might increase household’s willingness to pay for community-based health insurance

The effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia: A cross sectional study.

INTRODUCTION:Moving towards the goal of universal health coverage requires strengthening service delivery and overcoming significant financial barriers. The Government of Ethiopia is rolling out community based health insurance to protect the rural community from high out of pocket health expenditure and improve health service utilization. We investigated the effect of community based health insurance on catastrophic health expenditure in Northeast Ethiopia. METHODS:A community based cross sectional study was conducted. A Multi stage sampling technique was used to get a total of 454 (224 insured and 230 uninsured) households. The data were entered using EPI info version 7 and analyzed using SPSS version 20 and STATA version 13 for binary logistic regression analysis and propensity score matching analysis respectively. Wealth status of the households was computed by Principal Component Analysis (PCA). A multivariable logistic regression analysis was done to identify the predictors of catastrophic health expenditure. Propensity score matching analysis was used to determine the effect of community based health insurance on catastrophic health expenditure. The average treatment effect on the treated (ATT) was calculated to compare the means of outcomes across insured and uninsured households. RESULTS:A total of 454 household heads were included in the study, making a response rate of 91.2%.The total level of catastrophic health expenditure was found to be 20%. Among the households with catastrophic health expenditure, 4.41% were insured, whereas the remaining 15.64% were noninsured. Insured households (AOR = 0.19, 95% CI: 0.11-0.34), rich households (AOR = 1.98; 95% CI: 1.07-3.66), having member with chronic illness (AOR = 2.13, 95% CI: 1.01-4.51) and having member encountered any illness during the past 3 months (AOR = 2.44, 95% CI: 1.35-4.40) were statistically associated with catastrophic health expenditure. Community based health insurance contributed to 23.2% (t = -5.94) (95% CI: -0.31_-0.15) reduction of catastrophic health expenditure. CONCLUSION:The overall level of catastrophic health expenditure was high among noninsured households. Community based health insurance has significant financial protection from catastrophic health expenditure in northeast Ethiopia. Thus, the government need to scale up community based health insurance to protect the noninsured households from catastrophic health expenditure

Time to initiate complementary feeding and associated factors among mothers with children aged 6–24 months in Tahtay Maichew district, northern Ethiopia

Abstract Objective In Ethiopia, only 51% of the infants start complementary feeding on time. Therefore this study is aimed to determine the time to initiate complementary feeding and associated factors among mothers with children aged 6–24 months in Tahtay Maichew district, northern Ethiopia. A retrospective follow up study was conducted among 639 mothers who had children aged 6–24 months. Bi-variable and multi-variable Cox regressions were conducted and statistical significance was declared at P-value < 0.05 and 95% confidence level. Results The median age for the initiation into complementary feeding was 6.00 months. Being government employee [AHR = 1.67, 95% CI 1.10–2.53], having educated husband [AHR = 2.08, 95% CI 1.22–3.86], birth preparedness [AHR = 3.74, 95% CI 1.49–9.94], growth monitoring [AHR = 5.79, 95% CI 2.60–12.88], ability to know exact time to introduce complementary feeding [AHR = 4.93, 95% CI 1.94–12.50], and paternal support [AHR = 4.99, 95% CI 2.02–12.34] were significantly associated with the time to initiate into complementary feeding. Therefore, establishing breast feeding centres at work place and extending maternity leave for reasonable months are important to improve timely initiation into complementary feeding