Willingness to Pay for Proposed Social Health Insurance among Governmental Primary and Secondary School Teachers in Harar Town, Harari Region, Eastern Ethiopia

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 ix adequate awareness creation and discussion should be made with all employees at various levels for the successful implementation of the scheme