Dataset Information

Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia.

ABSTRACT: BACKGROUND:Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health professionals. METHODS:A cross-sectional study was conducted in Addis Ababa, Ethiopia, from May 1st to August 15th, 2019. A total sample of 480 health care providers was selected using a multistage sampling method. The collected data were entered into Epi Info version 7.1 and analyzed with SPSS version 23. Binary and multiple logistic regression analysis was carried out to identify the associated factor outcome variable. The association was presented in odds ratio with 95% confidence interval and significance determined at a P value less than 0.05. RESULT:A total of 460 health care providers responded to the questionnaire, making a 95.8% response rate. Of the respondents, only 132 (28.7%) were WTP for SHI. Higher educational status [AOR = 2.9, 95% CI (1.2-7.3)], higher monthly income [AOR = 2.2, 95% CI (1.2-4.3)], recent family illness [AOR = 2.4, 95% CI (1.4-4.4)], and a good awareness about SHI [AOR = 4.4, 95% CI (2.4-7.8)] showed significant association with WTP for SHI. The main reasons for not WTP were thinking the government should cover the cost, preferring out-pocket payment and the provided SHI scheme does not cover all the health care costs health care providers lost interest in pay for SHI. CONCLUSION AND RECOMMENDATION:The majority of health care providers were not willing to pay for the introduced SHI scheme. The provided SHI scheme should be clear and provide special consideration for health care providers as the majority of them receives free health care service from their employer health care institution. Also, the government, health professional associations, and other concerned stakeholders should provide awareness creation programs by targeting low and middle-level health professionals in order to increase WTP for SHI among health care providers.

SUBMITTER: Mekonne A

PROVIDER: S-EPMC7178532 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia.

Mekonne Abel A Seifu Benyam B Hailu Chernet C Atomsa Alemayehu A

BioMed research international 20200414

<h4>Background</h4>Cost sharing between beneficiaries and government is critical to attain universal health coverage. The government of Ethiopia introduced social health insurance to improve access to quality health services. Hence, HCP are the ultimate frontline service provider; their WTP for health insurance could influence the implementation of the scheme directly or indirectly. However, there is limited evidence on willingness to pay (WTP) for social health insurance (SHI) among health prof ...[more]

PMID: 32352010

Similar Datasets

Project description:BackgroundEthiopia plans to introduce social health insurance with the aim of giving recipients high-quality, long-term universal health care. It was anticipated to be fully operational in 2014. However, due to strong opposition from public employees, the implementation has been delayed multiple times. As a result, more and more studies have been conducted to collect evidence about the issue. However, there is no national pooled evidence regarding the willingness to pay for the scheme. Thus, this review aimed to evaluate the willingness to pay for social health insurance and associated factors in Ethiopia.MethodsOn September 1, 2022, database searches were conducted on Scopus, Hinari, PubMed, Google Scholar, and Semantic Scholar. Based on this search, 19 studies were included in the review. The risk of bias for the included studies was assessed using Joana Briggs Institute checklists. The data were extracted using Microsoft Excel. RevMan-5 was used to conduct the meta-analysis. The effect estimates assessed were the odds ratios at a p-value <0.05 with a 95% CI using the random effect model.ResultsThe pooled willingness to pay for social health insurance was 42.25% and was found to be affected by sociodemographic, health and illness status, health service related factors, awareness or knowledge level, perception or attitude toward the scheme, and factors related to the scheme. The pooled result showed that the willingness of participants to pay for the scheme was 16% less likely (OR = 0.84; 95% CI: 0.52-1.36). When the outlier was unchecked, the willingness to pay became 42% less likely (OR = 0.58; 95% CI: 0.37-0.91). The lowest willingness to pay for the scheme was in the Oromia region, while the highest was in Harar. Professionally, teachers were 3.22 times more likely to pay for the scheme (OR = 3.22; 95% CI: 1.80-5.76) than health professionals.ConclusionThe willingness to pay for social health insurance was low, <50%, particularly among health professionals, which urges the Ethiopian health insurance service to deeply look into the issue.

Project description:BackgroundMany low and middle-income countries are increasingly cognisant of the need to offer financial protection to its citizens through pre-payment schemes in order to curb high out of pocket expenditure and catastrophic spending on healthcare. However, there is limited rigorous contextual evidence to make decisions regarding optimal design of such schemes. This study assesses the willingness-to-pay (WTP) for the recently introduced state contributory health insurance scheme (SHIS) in Nigeria.MethodsThe study took place in 6 local government areas in Kaduna state, North-west Nigeria. Data were collected from a household survey using a three-stage cluster sampling approach, with each household having the same probability of being selected. Interviews were conducted with 4000 individuals in 1020 households. Contingent valuation was used to elicit the willing to pay (WTP) for the household using the bidding game technique. The relationship between socioeconomic status and WTP was also examined using logistic regression models.FindingsAbout 82% of the household heads were willing to pay insurance premiums for their households, which came to an average of 513 Naira (1.68 USD) per month per person. The average amount individuals were willing to pay was lower in rural areas (611 Naira) compared to urban areas (463 Naira). These results were influenced by household size, level of education, occupation and household income. In addition, only 65% of the households had the ability to pay the average premium.ConclusionSocioeconomic factors influence individuals' WTP for contributory health insurance schemes. It is important to create awareness about the benefits of the insurance scheme, especially in rural areas, and in both the formal and informal sectors in Nigeria. WTP information can inform the amount of insurance premiums. However, it is important to consider differences between the WTP and the cost of benefits package to be offered, as the premium amount may need to be subsidized with public financing.

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:BackgroundCommunity-based Health Insurance (CBHI) is a voluntary prepayment mechanism that guarantees the provision of basic healthcare services without financial barriers to underserved segments of the population in developing countries. The Government of Ethiopia launched the CBHI program to protect the community from high out-of-pocket health expenditure and improve health service utilization a decade ago. However, to improve the quality of healthcare services delivery in health facilities and cover the changing costs of healthcare, the government should revise the contribution of the CBHI scheme. Therefore, we determined the willingness to pay for a CBHI scheme and associated factors among rural households of Lemu and Bilbilo district, South Central Ethiopia.MethodsWe conducted a community-based cross-sectional study design to assess willingness to pay for the CBHI scheme and its associated factors among households in Lemu and Bilbilo districts, South Central Ethiopia. We used a double bounded contingent valuation method to elicit households' willingness to pay for the CBHI scheme. Data were coded, cleaned, entered into Statistical Package for Social Science (SPSS) version 25, and exported to STATA 16 for analysis. A logistic regression analysis was conducted to determine the presence of statistically significant associations between the willingness to pay for the CBHI scheme and independent variables at a p-value <0.05 and Adjusted odds ratio (AOR) values with 95% CI. Finally, we checked the fitness of the model using Hosmer and Lemeshow's goodness-of-fit test.ResultsOf the 476 study participants, 82.9% (95% CI: 79.2%, 86.01%) were willing to pay for the CBHI scheme and only 62% of them can afford the average amount of 358.32ETB ($7.68) per household per annum. Primary education (AOR = 3.17; 95% CI: 1.74-5.80), secondary and above education (AOR = 4.13; 95% CI: 1.86-9.18), large family size (AOR = 2.75; 95% CI: 1.26-5.97), monthly income of 500-1000ETB (AOR = 3.75; 95% CI: 1.97-7.13) and distance to public health facilities (AOR = 2.14, 95% CI: 1.04-4.39 were significantly associated with willingness to pay for the CBHI scheme.ConclusionIn this study, around 83% of respondents were willing to pay for the CBHI and meet the government expectation for 2020. The study also revealed that educational status, family size, monthly income, and distance from the health facilities were significant factors associated with WTP for the CBHI scheme. In addition, we found that a large number of the respondents couldn't afford the average amount of money that the participants were willing to pay for the CBHI scheme. So, the government should consider the economic status of the communities while revising the CBHI scheme premium not to miss those who cannot afford the contribution.

Project description:BACKGROUND:Depression is a common co-morbid, disabling disorder that affects 10-25% of cancer patients. It causes substantial functional impairment and lowers survival rate of breast cancer patients. Therefore, the aim of this study is to determine the magnitude of depression and its association with social support among breast cancer patients in Addis Ababa, Ethiopia. METHODS:A cross-sectional study which included 428 breast cancer patients was conducted in seven health facilities in Addis Ababa, Ethiopia. Depression and Social Support were assessed using standard tools Patient Health Questionnaire 9 (PHQ 9) and Multidimensional Scale of Perceived Social Support (MSPSS) respectively. Descriptive statistics were done based on the standard PHQ9 cut off points (0-4, 5-9, 10-14, 15-19 and???20). Mann-Whitney and Kruskal Wallis tests were employed to compare MSPSS score among depressed and non-depressed patients and across the different levels of depression. Bivariate and multivariate logistic regression was done to identify factors associated with depression. RESULT:The prevalence of depression among breast cancer patients was 25% (107/428), andaccording to the PHQ9 score categorization, 70/428 (16.4%), 30/428 (7.01%) and 7/428 (1.64%) of these patients were having moderate, moderately severe and severe depression respectively. Age, occupation, type of health facility treated, severity of pain, hormonal therapy and having problem with employer/ family were significantly associated with depression. The participants' MSPSS total score was overall found to be high (70.35?±?16.81). Those women who had moderate and severe depression had lower mean MSPSS scores compared to women with none/ minimal depression (P =?0.002). CONCLUSION:This study found that one in four breast cancer patients had depression. Depression is associated with poor social support given by family, friends and significant others. Therefore, screening for depression and psychosocial service should be integrated in the routine breast cancer care in Ethiopia.

Project description:BACKGROUND:Despite the presence of high impact interventions to improve infant and young child feeding, only about 52% of mothers in Ethiopia exclusively breastfeed their child for the first six months after delivery. Although the decision to breastfeed a child is ultimately that of the mother, this decision could be influenced by a variety of factors including social-cognitive ones. OBJECTIVES:The objectives of the study were to describe the breastfeeding behaviour of primiparous mothers during their prenatal period in terms of intentions/goals, outcome expectancies, self-efficacy, and socio-structural factors and assess their exclusive breastfeeding (EBF) practices as well as identify the social-cognitive predictors of EBF practices among these mothers in Addis Ababa, Ethiopia. METHODS:A prospective follow up health facility-based study with quantitative methods was used with a sample of 233 primiparous women. Both structured and semi-structured questions were used for collection of data. The Statistical Package for Social Sciences (SPSS) version 21 was used for data analysis. Findings at the 95% confidence interval and P-value of 5% were reported as statistically significant. RESULTS:39.1% (n = 59) of the respondents were found to have high breastfeeding self-efficacy, 51.4% (n = 71) have good breastfeeding outcome expectancies, and 6.5% (n = 9) respondents had supportive breastfeeding socio-structural factors. Bivariate correlation analysis showed positive and statistically significant correlation between each of breastfeeding self-efficacy, outcome expectancy, and socio-structural factors, with EBF practice. However, only breastfeeding self-efficacy and outcome expectancies were statistically significant predictors of EBF among the primiparous women when controlling for confounding variables. CONCLUSIONS AND RECOMMENDATIONS:Health programmes aimed at improving EBF among primiparous mothers should look beyond providing health information alone. Rather improving primiparous women's breastfeeding self-efficacy and outcome expectancy is strongly recommended. Further community based large scale research is also recommended among similar groups of women.

Project description:BackgroundCommunity-based health insurance programs are being acknowledged as effective strategies to attain universal health coverage and mitigate the financial catastrophic shock of the community. Even though Ethiopia has been focusing on the implementation and expansion of a community-based health insurance (CBHI) program since 2011, only a small number of people are enrolled, which might be attributed to a lack of willingness towards the program. The purpose of this study is to determine the willingness to pay for community-based health insurance and associated factors among households in the rural community of Gombora District, Hadiya Zone, southern Ethiopia.MethodsUsing the multistage systematic random sampling technique, a sample of 421 households was chosen for a community-based cross-sectional study. The desired information was gathered using a pre-tested, structured, interviewer-administered questionnaire. The data was entered using Epi-Data V3.1 and exported to SPSS version 24.0 for statistical analysis. Bivariable and multivariable logistic regression analyses were performed to determine the variables associated with the willingness to pay for community-based health insurance.ResultsThe study showed that 67.1% of respondents expressed a willingness to pay for community-based health insurance. The mean amount of money they are willing to pay for the scheme is 178.41 (± 57.21) Ethiopian Birr (ETB), or 6.43 (± 2.06) USD per household per annum in 2020. Based on multiple logistic regression analysis, belonging to Rich household compared to poor (AOR: 2.78, 95% CI: 1.54, 5.03), having a household head who can read and write (AOR: 2.90, 95% CI: 1.39, 6.05), family size greater than five (AOR: 1.76, 95% CI: 1.06, 2.92), indigenous community insurance (iddir) participation (AOR: 2.83, 95% CI: 1.61, 4.96), and the presence of chronic illness (AOR: 1.94, 95% CI: 1.21, 3.12), were significantly associated with the willingness to pay for a CBHI scheme.ConclusionHouseholds' willingness to pay for a CBHI scheme was found to be significantly influenced by poor household wealth status, household heads who cannot read and write, households with less than or equal to five family members, households who participate in greater or equal to two indigenous community insurance participations, and the absence of chronic illness within the household. Therefore, factors affecting households' willingness to pay should be considered and massive community mobilization needs to be done to strengthen and increase household membership during the implementation of the CBHI scheme, especially in rural areas.

Dataset Information

Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia.

Publications

Willingness to Pay for Social Health Insurance and Associated Factors among Health Care Providers in Addis Ababa, Ethiopia.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets