Dataset Information

Civil servants' demand for social health insurance in Northwest Ethiopia.

ABSTRACT:

Background

Absence of reliable health insurance schemes is a key challenge to meet the universal health coverage target of the Sustainable Development Goals (SDGs). Ethiopian health system is characterized by under financing, low protection mechanisms for the poor, and lack of mechanisms of risk pooling and cost sharing. Ethiopia is implementing social health insurance (SHI) scheme to reduce out of pocket payment (OOP) and improve access and use of healthcare. This study aimed to determine the demand for SHI among civil servants and associated factors in Northwest Ethiopia.

Methods

An institution-based cross-sectional study was conducted in Bahir Dar city from 557 randomly selected civil servants using structured and self-administered questionaire. The questionnaire included questions measuring demand for SHI and demographic, socio-economic, healthcare related and personal and behavioral factors. Data were first entered in Epi-Info version 7.0 and transferred to SPSS version 20 for analysis. Descriptive statistics, bivariate and multivariable logistic regression analysis were performed.

Results

From the total calculated sample size of 557, 488 respondents returned the questionnaire giving a response rate of 88%. Nearly three-fourth of the respondents, 355 (72.7%), reported their need to be enrolled in a SHI scheme. Two-third of the respondents 325 (66.6%) were willing to pay for their enrollment. Overall, three hundred and two (61.9%) were demanding SHI. Having good awareness about health insurance [AOR?=?4.39, 95% CI?=?(1.82-12.89)] and trust on a health insurance agency [AOR?=?3.0, 95% CI?=?(1.57-5.72)], were significantly associated with the demand for SHI among civil servants.

Conclusion

The demand for SHI among civil servants were higher. The awareness towards SHI and trust on the SHI agency were significantly associated with demand for SHI. As Ethiopia aspires to insure all employees of the formal sector, and improving the awareness of civil servants about SHI and the agency providing the service could improve demand for SHI. Further research is important on healthcare organizational and professional readiness to handle the upcoming insurance driven quality health service need and health seeking behavioral change.

SUBMITTER: Yeshiwas S

PROVIDER: S-EPMC6136157 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Publications

Civil servants' demand for social health insurance in Northwest Ethiopia.

Yeshiwas Sahilu S Kiflie Mengistu M Zeleke Atinkut Alamirrew AA Kebede Mihiretu M

Archives of public health = Archives belges de sante publique 20180913

<h4>Background</h4>Absence of reliable health insurance schemes is a key challenge to meet the universal health coverage target of the Sustainable Development Goals (SDGs). Ethiopian health system is characterized by under financing, low protection mechanisms for the poor, and lack of mechanisms of risk pooling and cost sharing. Ethiopia is implementing social health insurance (SHI) scheme to reduce out of pocket payment (OOP) and improve access and use of healthcare. This study aimed to determi ...[more]

PMID: 30221001

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Project description:BackgroundOwing to lack of adequate healthcare financing, access to at least the basic health services is still a problem in Ethiopia. With the intention of raising funds and ensuring universal health coverage, a mandatory health insurance scheme has been introduced. The Community Based Health Insurance has been implemented in all regions of the country, while implementation of social health insurance was delayed mainly due to resistance from public servants. This study was, therefore, aimed to assess willingness to pay for social health insurance and its determinant factors among public servants in Mekelle city, Northern Ethiopia.MethodsA concurrent mixed approach of cross-sectional study design using double bound dichotomous choice contingent valuation method and qualitative focus group discussions was employed. A total 384 public servants were recruited from randomly selected institutions and six focus group discussions (n = 36) were carried out with purposively selected respondents. Participants' mean willingness to pay (WTP) and independent predictors of WTP were identified using an interval data logit model. Qualitative data were analyzed using thematic analysis.ResultsFrom the 384 participants, 381 completed the interview, making a response rate of 99.2%. Among these respondents 85.3% preferred social health insurance and were willing to pay for the scheme. Their estimated mean WTP was 3.6% of their monthly salary. Lack of money to pay (42.6%) was the major stumbling block to enrolling in the scheme. Respondents' WTP was significantly positively associated with their level of income but their WTP decreased with increasing age and educational status. On the other hand, a majority of focus group discussion participants were not willing to pay the 3% premium set by the government unless some preconditions were satisfied. The amount of premium contribution, benefit package and poor quality of health service were the major factors affecting their WTP.ConclusionThe majority of the public servants were willing to be part of the social health insurance scheme, with a mean WTP of 3.6% of their monthly salary. This was greater than the premium proposed by the government (3%). This can pave the way to start the scheme but attention should focus on improving the quality of health services.

Project description:IntroductionHypertension is the leading cause of death and disability in adult populations globally. Its prevalence is increasing rapidly in Ethiopia. Studies conducted to date address different population categories. However, there is lack of data on the prevalence and risk factors of hypertension among civil servants working in various sectors and levels.ObjectiveTo assess the prevalence and risk factors of hypertension among civil servants in Sidama Zone, south Ethiopia.Methods and materialsAn institution-based cross-sectional study was conducted from March 1-30, 2019 on a sample of 546 civil servants selected randomly from different departments of Sidama Zone Administration. Data were collected using structured, face-to-face interviewer-administered questionnaire and standard physical measurements. The data were entered using Epi Data 3.1 and analyzed using SPSS version 20. Multivariable logistic regression analysis was used to identify factors associated with hypertension. Adjusted odds ratios (AORs) with 95% confidence interval (CI) were computed to assess the presence and strength of associations.ResultsA total of 546 civil servants responded resulting in a response rate of 94.9%. The prevalence of hypertension was 24.5% [95% CI: 23.3% - 25.6%]. The identified risk factors of hypertension were male sex (AOR 4.31[95% CI: 1.84-10.09]), moderate current alcohol consumption (AOR: 4.85; [95% CI: 1.73-13.61]), current khat chewing (AOR 2.97[95% CI: 1.38-6.40]), old age (AOR: 4.41[95% CI: 1.19-16.26]), being obese (AOR 5.94 [95% CI: 1.26-27.86]) and central obesity (AOR 3.57 [95% CI: 1.80-7.07]).ConclusionsOne in four civil servants are hypertensive. Different demographic, behavioral and metabolic factors increase the odds of hypertension among civil servants. Prevention and control of hypertension shall involve promotion of healthy lifestyles such as weight management, regular physical activity and quitting or cutting down on harmful use of substances such as alcohol and khat.

Project description:BackgroundIn 2022, the World Health Organization highlighted the alarming state of oral health (OH) worldwide and urged action to include OH in initiatives on noncommunicable diseases. The population needs improved OH skills and attitudes and an adequate level of OH literacy (OHL) and general health literacy (HL). The implementation of health promotion actions in the workplace, which is a part of most people's lives, appears to be an opportunity. In France, civil servants have several socioprofessional levels and represent an excellent model with results transposable to the population.ObjectiveThis study aimed at determining the OHL and HL level of civil servants in France in order to implement specific prevention actions in their workplaces.MethodsA cross-sectional study of French civil servants was conducted in France from October 2023 to February 2024. Participants completed three validated questionnaires in French: (1) a questionnaire on OH knowledge, (2) the Oral Health Literacy Instrument, French version (OHLI-F; this is composed of reading comprehension and numeracy sections) to assess the OHL level, and (3) the Short Test of Functional Health Literacy in Adults, French version (s-TOFHLA-F) to assess the HL level. The scores for OH knowledge, the OHLI-F, and the s-TOFHLA-F were reported as means (SD) and the 95% CI. These scores were classified into 3 categories: adequate (75-100), marginal (60-74) and inadequate (0-59). ANOVA and binary logistic regression were performed. The OHLI-F reading comprehension and OHLI-F numeracy scores were compared using the Welch 2-sample t test and a paired t test (both 2-tailed). For the correlation matrix, the Pearson correlation and related tests were computed.ResultsA total of 1917 persons completed the 3 questionnaires, with adequate levels of OHL (n=1610, 84%), OH knowledge (n=1736, 90.6%), and HL (n=1915, 99.9%). The scores on the s-TOFHLA-F (mean 98.2, SD 2.8) were higher than the OHLI-F (mean 80.9, SD 7.9) and OH knowledge (mean 87.6, SD 10.5). The OHLI-F was highly correlated with OH knowledge (P<.001), but the OHLI-F and OH knowledge had a low correlation with s-TOFHLA-F (P=.43). The OHLI-F reading comprehension score was significantly higher than the OHLI-F numeracy score (P<.001). Age, education level, and professional category impacted the 3 scores (P<.001). The professional category was a determinant of adequate OHLI-F and OH knowledge scores.ConclusionsSome French civil servants had inadequate or marginal levels of OH knowledge (n=181, 9.5%) and OHL (n=307, 16%) but none had an inadequate level of HL. Results highlighted the relevance of implementing OH promotion programs in the workplace. They should be nonstandardized, adapted to the literacy level of professional categories of workers, and focused on numeracy skills. Thus, appropriate preventive communication and improved literacy levels are the means to achieve greater disease equity and combat the burden of noncommunicable diseases.

Project description:ObjectiveThe objective of this study was to assess voluntary blood donation practice and associated factors among Bale Robe town civil servants in Oromia, Southeast Ethiopia, 2021.MethodsAn institution-based cross-sectional study was conducted among 601 civil servants selected by a stratified systematic random sampling technique. Data were collected using a structured self-administered questionnaire. The questionnaire was pre-tested on 5% of the total sample size before actual data collection. Data were coded and entered into EpiData version 3.1 and analyzed using SPSS version 25. Frequency distribution, descriptive statistics, and diagrams were used to summarize and present data. Binary logistic regression was performed to assess the association between independent variables and voluntary blood donation practice. An adjusted odds ratio (AOR) with its 95% confidence interval (CI) was calculated to identify factors associated with the outcome variables. And p-value < 0.05 was used to declare significance.ResultOf the total of 630 selected civil servants, 601 give a complete response to the questionnaire yielding a response rate of 95%. The mean age of participants was 34.19 years, and 328 (54.6%) of them were rural residents before they joined the governmental work. The lifetime voluntary blood donation practice among civil servants was 27%; 95% confidence interval = (23%-31%). The major reason for not donating blood was fear related to blood donation 186 (42.4%). From multivariable logistic regression, four variables were found as significant independent variables associated with voluntary blood donation practice. Accordingly, having a family member or relative who previously donate blood (adjusted odds ratio = 2.48; 95% confidence interval = (1.39, 4.39)), previous participation in a blood donation campaign (adjusted odds ratio = 5.84; 95% confidence interval = (3.39, 1.04)), and willingness to donate blood (adjusted odds ratio = 5.04; 95% confidence interval = (2.21, 11.48)) were variables significantly and positively associated with voluntary blood donation practice, respectively. Civil servants who had no opportunity to donate blood previously were less likely to give voluntary blood donation (adjusted odds ratio = 0.15 (95% confidence interval = 0.063, 0.367)).ConclusionThe study identified a low level of voluntary blood donation. Having family members/relatives who donate blood, previous participation in a blood donation campaign, and willingness to donate blood were significantly associated with voluntary blood donation. Therefore, there should be regularly scheduled campaigns encouraging civil servants' voluntary blood donation.

Project description:BackgroundAbdominal obesity increases the risk of cardio-metabolic diseases, disability, and poor quality of life, as well as health-care costs. It is a component of the metabolic syndrome, along with hypertension, diabetes, and dyslipidemia. The goal of this study was to determine the prevalence of abdominal obesity and associated risk factors among female civil servants in Addis Ababa, Ethiopia in 2021.MethodsAn institution-based cross-sectional study was undertaken from March31st to April 15th, 2021.A multi-stage sampling technique was employed to select 478 study participants. Data was entered into EpiData version 3.1 and then exported to SPSS version 21 for analysis. A descriptive data analysis was used to present the distribution of study variables. Bivariable and multivariable analyses were used to assess the relationship between independent variables and abdominal obesity at 95% CI. The level of statistical significance was declared at a p-value less than 0.05.ResultThe prevalence of abdominal obesity defined by waist circumference was found to be29.5% (95% CI: 25.39-33.6%) and 32.8% (95% CI: 28.57%-37.03%) by waist hip ratio, respectively. Age group 29-37 years [AOR= 2.451, 95% CI: (1.199-5.013)], age group 38-46 years [AOR=3.807, 95% CI: (1.328-10.914)], age group 47-55 years [AOR=6.489, 95% CI: (1.367-30.805)], being married [AOR= 4.762, 95% CI: (2.321-9.721)],consumption of meat >=5 per week[ AOR= 4.764, 95% CI: (1.939-11.711)], having lunch daily[AOR= 0.388, 95% CI:(0.166-0.910)] and snack consumption [AOR=4.163, 95% CI:(1.503-11.534)] were significantly associated with abdominal obesity.ConclusionThe prevalence of abdominal obesity as measured by waist circumference and waist hip ratio was found to be moderate and high, respectively. Age, being married, high consumption of meat, and having lunch daily were identified as associated with abdominal obesity. Healthy diet health education and nutrition intervention should be considered, with a focus on married, meat-consuming, and older age-group female civil servants.

Dataset Information

Civil servants' demand for social health insurance in Northwest Ethiopia.

Background

Methods

Results

Conclusion

Publications

Civil servants' demand for social health insurance in Northwest Ethiopia.

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