Abstract:
Background - Social health insurance is a financing scheme where money pool into common fund and used
for pay for health care cost of member of formal employee. However, there is little evidence on willingness
to pay for social health insurance and associated factor among governmental employee in low-income
countries like Ethiopia include Harar town.
Objective:-To assess the level of willingness to pay for proposed social health insurance and associated
factors among governmental primary and secondary school teachers in Harar town, eastern Ethiopia.
Methods:- Institution based cross-sectional study design was used among 471 primary and secondary
school teachers in Harar town. A stratified random sampling technique was used to select the study
participants. The data were collected using a structured pretested self administered questionnaire.
Descriptive statistics such as frequencies, proportion, and numerical summary measures were used to
describe the study population in relation to relevant variables. Bivariable analyses were carried out to see
the association between each independent variable and the dependent variable. All variables with p value
less than 0.25 during bivariable analyses were entered into multivariable analysis to control for all possible
confounders and to identify factors associated with the outcome variable Odds ratio along with
95%confidence interval was estimated to measure the strength of the association. Level of statistical
significance was declared at p-value less than 0.05. The result was display using table and graph.
Result:-The level of willingness to pay for social health insurance was 20.6%; [95%, CI :( 16.2%, 24.6%)].
In multivariable analyses, age less than 24years [AOR=5.47; 95%CI:(1.76,16.93)], age between
25-29years[AOR=2.04 ; 95%CI:(1.00,4.16)] ,age between 30-34years [AOR=2.39; 95%CI:
(1.23,4.64)] age between 35-39years [AOR=2.17; 95%CI:(1.17,4.33)], male respondents
[AOR=2.34;95%CI: (1.39,3.92)], length of service year less than 5years [AOR= 2.74;95%CI
:(1.28,5.84)] and perceive that employees should pay for SHI [AOR= 8.39;95%CI
:(3.56,19.73)]and perceive that government should pay for SHI [AOR=4.28;95%CI
:(1.69,10.91)]were significantly associated with willingness to pay for social health insurance .
Conclusion:- Willingness to pay for social health insurance was found to be low in the study area.
Variables such as, age, sex, length of service year, and the perception about who should pay for insurance
had statistically significant association with willingness to pay for social health insurance. Therefore
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adequate awareness creation and discussion should be made with all employees at various levels for the
successful implementation of the scheme
