ACCEPTANCE TO PAY FOR COMMUNITY BASED HEALTH INSURANCE AND FACTORS ASSOCIATED AMONG HOUSEHOLD HEADS IN RURALCOMMUNITY OF GEMMACHIS DISTRICT, EASTERN ETHIOPIA

Abstract

Community based health insurance (CBHI) scheme is an effective financing mechanism to help people who are unable to use health care services due to financial problem. So Prior to scaling up community based health insurance; it is necessary to assess the magnitude of acceptance to pay and continuity of the reform however; no known regarding the level of acceptance to pay and factors associated in the study area. Objective: The aim of this study was to assess acceptance to pay for community based health insurance and factors associated among the household heads in Gemmachis Woreda, Eastern Ethiopia from April 10 to July/10/ 2019. Methods: Community based cross-sectional study design was employed to collect the data. Two stage sampling technique was used to select 446 household heads as study units which were allocated to the kebeles proportionately. The study population were selected household heads in the selected kebeles from which information was collected during data collection period. Data was collected using a structured pre tested questionnaire. The data was cleaned, coded, entered into Epi-data 3.1 software and transferred and analyzed using SPSS computer software version 20. Results: The study revealed that, 74.8% of participants had acceptance to pay for community-based health insurance. Based on the multivariate logistic regression model; Primary education (1-8 grade) (AOR=5.13, 95% CI, 2.37, 11.13), good Knowledge of CBHI (AOR=2.30, 95% CI, 1.49, 3.57), being house wives (AOR=3.83, 95% CI, 1.33, 11.03), any illness in the past (AOR=3.11, 95% CI, 1.86, 5.21), merchant by occupation (AOR= 0.23, 95% CI,0.10, 0.51)Poor wealth status (AOR=2.46, 95% CI, 1.27, 4.75) nearby health facility≤30 minutes (AOR=2.03, 95% CI, 1.12, 3.71) were significantly associated with acceptance to pay for community based health insurance. Conclusion: The finding of this study revealed that majority (74.8%) of the rural household heads in the study area had acceptance to pay for community based health insurance. We observed that primary education (1-8), merchant by occupation, house wife by occupation, good knowledge of CBHI, poor wealth status, nearby health facility≤30 minutes and having any illness in past one year were significant predictors. District health office management should mobilize and educate the community about the benefit package and principle of the scheme to better outcomes and success.