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Enrollment in community based health insurance program and the associated factors among households in Boricha district, Sidama Zone, Southern Ethiopia; a cross-sectional study.

ABSTRACT: BACKGROUND:In absence of any form of health insurance, out-of-pocket payments for health care lead to decreased use of health services and catastrophic health expenditures. Community-based health insurances has been promised financial model for informal sectors to reduce these problems in many countries. When this comes down to Ethiopia, in the South Nation Nationality People's Region of the country established 52 schemes including Boricha district, the study area However, there has been little evidence about the enrollment status and the associated factors in the study area in particular elsewhere in general. OBJECTIVE:The study aims to assess the current enrollment status of households in community based health insurance and the associated factors in Boricha district of Sidama Zone, Southern Ethiopia. METHODS AND MATERIALS:A community based cross-sectional study design was employed from February 01, 2019 to March 31, 2019, using a sample of 632 households. Data were collected using interviewer-administered pre-tested questionnaire and entered into EPI-Info 7and transported to SPSSversion20 for analysis. Multi-variable logistic regression analysis along with odds ratio and the corresponding 95% CI was conducted and significance was declared at P-value <0.05. RESULTS:Current enrollment status of households in community based health insurance was found to be 81 (12.8%). According to this study, educational status; secondary school& above[AOR = 2.749, 95%CI(1.142, 6.618)], timing of collecting premium [AOR = 0.433; 95% CI (0.196, 0.958)], family size ?5, [AOR = 4.16;95%CI (1.337, 12.944)], no trust on scheme management[AOR = 0.272; 95%CI (0.140, 0.528)], lack of information [AOR = 0.086; 95%CI (0.026, 0.288)], dissatisfaction with health care service received[AOR = 0.303; 95%CI (0.171, 0.537)], no chronic illness in the family[AOR = 0.259; 95%C.I.(0.137, 0.488)] were factors significantly associated with current enrollment status in CBHI. CONCLUSIONS:Households head's education status, timing of premium collection, family size, no trust on scheme management, lack of information, services dissatisfaction and chronic illness in the family member were the identified factors associated with enrollment in CBHI in the study area. Therefore, to enhance the enrollment and sustainability of CBHI in the study area awareness creation, improving timing of premium collection, strengthening scheme management, improving quality of service are the areas that decision makers needs to intervene.

SUBMITTER: Nageso D

PROVIDER: S-EPMC7266314 | biostudies-literature | 2020

REPOSITORIES: biostudies-literature

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Enrollment in community based health insurance program and the associated factors among households in Boricha district, Sidama Zone, Southern Ethiopia; a cross-sectional study.

Nageso Dawit D Tefera Kebede K Gutema Keneni K

PloS one 20200602 6

<h4>Background</h4>In absence of any form of health insurance, out-of-pocket payments for health care lead to decreased use of health services and catastrophic health expenditures. Community-based health insurances has been promised financial model for informal sectors to reduce these problems in many countries. When this comes down to Ethiopia, in the South Nation Nationality People's Region of the country established 52 schemes including Boricha district, the study area However, there has been ...[more]

PMID: 32484840

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Project description:BACKGROUND:Ethiopia is one of the species-rich countries in the world and the center of origin with regard to the diversity of many plant species. Ethnobotanical studies are vital to investigate these diverse biological resources for medicinal purposes. The aim of this study was to document the indigenous knowledge of the Sidama people regarding the use of medicinal plants to treat human and livestock diseases in the Hawassa Zuria district of Southern Ethiopia. METHODS:A total of 150 informants (118 men and 32 women) were selected to collect ethnobotanical information from ten kebeles by means of a stratified purposive sampling method. Among the informants, 30 key informants were selected purposefully. Ethnobotanical data were collected through semi-structured interviews and group discussions and were analyzed by descriptive statistics, informant consensus factor (ICF), fidelity level (FL), and ranking methods. RESULTS:A total of 105 medicinal plants distributed across 52 families and 96 genera were collected. Fabaceae (11 species) was represented by the highest number of plant species, followed by Lamiaceae (7 species). Herbs (34%) were the dominant growth habits, followed by trees (33%). Leaves (56%) were the dominant plant part used in the preparation of remedies, followed by fruit (15%). The most common method of remedy preparation was grinding (39%) followed by chewing and boiling (11% each). Oral (74%) was the major routes of administration, followed by dermal (20%). There was a significant knowledge difference (p < 0.05) between social groups regarding the use of traditional medicinal plants. Insects and ectoparasites disease category (0.95) had higher informant consensus factor value followed by fever disease category (0.91). Eucalyptus globulus Labill. (100%) had a higher fidelity level to treat stomachache, followed by Ensete ventricosum (Welw.) Cheesman. (87.27%) to treat placenta delay. Ensete ventricosum (total score = 73) was ranked highest as the most preferable medicinal plant for various purposes by local people, followed by Olea welwitschii (Knobl.) Gilg (total score = 72). CONCLUSION:The present study revealed the existence of indigenous knowledge of medicinal plants to treat human and livestock ailments. However, agricultural expansion, firewood collection, environmental degradation, and deforestation are the main threats to medicinal plants. Therefore, there should be mentoring for the local people in the study area to conserve their indigenous knowledge resources and prevent the extinction of medicinal plants.

Project description:IntroductionDisrespect and abusive care is a violation of women's basic human rights and it is serious global problem that needs urgent intervention. Poor quality client-provider interaction is commonly reported from family planning programmes. In Ethiopia, disrespect and abusive care is very common (21-78%) across health facilities.ObjectiveTo assess the status of respectful family planning service (client-provider interaction) in Sidama zone, south Ethiopia.MethodologyHealth facility-based cross-sectional study was conducted from June to August 2018. Data were collected from 920 family planning clients recruited from 40 randomly selected health facilities. The Mother on Respect index (MORi) questionnaire was used to collect the data through client exit interview. Partial proportional odds ordinal regression was employed to identify determinants of respectful family planning service.ResultAmong family planning clients, the level of respectful family planning service was found to be zero (0%) in the very low respect category, 75(18.5%) in the low respect category, 382(41.52%) in moderate respect category and 463(50.33%) in high respect category. Being a short acting method client (AOR = 0.30, 95%CI [0.12, 0.72]), being an uneducated client (AOR = 0.39, 95%CI [0.25, 0.61]) or a client with elementary education (AOR = 0.41, 95%CI [0.23, 0.73]), client's poverty (AOR = 0.75, 95%CI [0.56, 0.99]), and long waiting time (AOR = 0.46, 95%CI [0.30, 0.69])significantly reduced the odds of moderate and high respect compared to low respect. Conversely, preference of male service providers, service providers' work satisfaction and health workers' prior training on respectful care significantly increased the odds of moderate and high respect.ConclusionConsidering the current strategy of zero tolerance for disrespect and abuse in Ethiopia, the level of respectful care in this study is sub-optimal. Short term training for service providers on respectful care seems valuable to enhance the level of respectful care for family planning clients irrespective of their socioeconomic background.

Project description:BACKGROUND:Tuberculosis (TB) is a disease of public health concern, with a varying distribution across settings depending on socio-economic status, HIV burden, availability and performance of the health system. Ethiopia is a country with a high burden of TB, with regional variations in TB case notification rates (CNRs). However, TB program reports are often compiled and reported at higher administrative units that do not show the burden at lower units, so there is limited information about the spatial distribution of the disease. We therefore aim to assess the spatial distribution and presence of the spatio-temporal clustering of the disease in different geographic settings over 10 years in the Sidama Zone in southern Ethiopia. METHODS:A retrospective space-time and spatial analysis were carried out at the kebele level (the lowest administrative unit within a district) to identify spatial and space-time clusters of smear-positive pulmonary TB (PTB). Scan statistics, Global Moran's I, and Getis and Ordi (Gi*) statistics were all used to help analyze the spatial distribution and clusters of the disease across settings. RESULTS:A total of 22,545 smear-positive PTB cases notified over 10 years were used for spatial analysis. In a purely spatial analysis, we identified the most likely cluster of smear-positive PTB in 192 kebeles in eight districts (RR= 2, p<0.001), with 12,155 observed and 8,668 expected cases. The Gi* statistic also identified the clusters in the same areas, and the spatial clusters showed stability in most areas in each year during the study period. The space-time analysis also detected the most likely cluster in 193 kebeles in the same eight districts (RR= 1.92, p<0.001), with 7,584 observed and 4,738 expected cases in 2003-2012. CONCLUSION:The study found variations in CNRs and significant spatio-temporal clusters of smear-positive PTB in the Sidama Zone. The findings can be used to guide TB control programs to devise effective TB control strategies for the geographic areas characterized by the highest CNRs. Further studies are required to understand the factors associated with clustering based on individual level locations and investigation of cases.

Project description:BackgroundDespite the efforts made by the government of Ethiopia, the community-based health insurance (CBHI) enrollment rate failed to reach the potential beneficiaries. Therefore, this study aimed to assess the enrollment status of households for community-based health insurance and associated factors in peripheral areas of Southern Ethiopia.MethodsWe conducted a community based cross-sectional study design with both quantitative and qualitative methods. Systematic random sampling was employed to select 820 households from 27, April to 12 June 2018. A pretested structured questionnaire, in-depth interview, and focus group discussion guiding tool were used to obtain information. A binary logistic regression model was used to assess the association between independent and outcome variables. A P-Value of less than 0.05 was taken as a cutoff to declare association in multivariable analysis. Qualitative data were analyzed manually using the thematic analysis method.ResultsOut of 820 households, 273[33.30%; 95% CI: 29.9-36.20] were enrolled in the community based health insurance scheme. Having good knowledge [AOR = 13.97, 95%CI: 8.64, 22.60], having family size of greater than five [AOR = 1.88, 95% CI: 1.15, 3.06], presence of frequently ill individual [AOR = 3.90, 95% CI: 2.03, 7.51] and presence of chronic illness [AOR = 3.64, 95% CI: 1.67, 7.79] were positively associated with CBHI enrollment. In addition, poor quality of care, lack of managerial commitment, lack of trust and transparency, unavailability of basic logistics and supplies were also barriers for CBHI enrollment.Conclusion and recommendationThe study found that lower community based health insurance enrollment status. A higher probability of CBHI enrollment among higher health care demanding population groups was observed. Poor perceived quality of health care, poor managerial support and lack of trust were found to be barriers for non-enrollment. Therefore, wide-range awareness creation strategies should be used to address adverse selection and poor knowledge. In addition, trust should be built among communities through transparent management. Furthermore, the quality of care being given in public health facilities should be improved to encourage the community to be enrolled in CBHI.

Project description:BackgroundVarious countries in the world have achieved promising progress in promoting, protecting and guaranteeing sexual and reproductive health rights (SRHRs) since the 1994 International Conference on Population and Development (ICPD) in Cairo. However, SRHRs have not been recognized to their maximum potential in Ethiopia, despite the domestication of the international instruments related to their successful implementation. This study was intended to determine the magnitude of SRHRs knowledge, reproductive health services utilization and their independent predictors among rural reproductive-age women in the Aleta Wondo District, Ethiopia.MethodsA community-based cross-sectional study was conducted among 833 rural reproductive-age women from April to May 2019. A systematic random sampling technique was employed to select households, and a structured questionnaire was used to gather the data. EPI INFO version 7 was used to enter the data, and SPSS version 23 was used for data analysis. Logistic regression analysis was employed to assess the association between outcomes and explanatory variables. Odds ratios at 95% CI were also computed and reported.ResultsOf 833 respondents, 43.9% had good knowledge of SRHR, and 37% had used at least one sexual and reproductive health (SRH) service. Variables that had a statistically significant association with SRHR knowledge in multivariable analysis were: had formal education, household with the highest income, having information sources for SRH services, and knowing about SRH services and providing institutions. SRH services utilization was associated with: having information sources for SRH services, had formal education, household with the highest income, and knowing about SRH services and providing institutions.ConclusionIn this study demographic and economic factors, such as education and household monthly income were positively identified as independent predictors for knowledge of SRHR and SRH services utilization. Therefore, responsible government sectors and NGOs should design and implement programs to promote women's educational status and household economic status to enhance women's SRHR knowledge and SRH services utilization.

Project description:BACKGROUND:In 2015 the maternal mortality ratio for Ethiopia was 353 per 100,000 live births. Large numbers of women do not use maternal health services. This study aimed to identify factors influencing the use of maternal health services at the primary health care unit (PHCU) level in rural communities in Sidama zone, south Ethiopia in order to design quality improvement interventions. METHODS:We conducted a qualitative study in six woredas in 2013: 14 focus group discussions (FGDs) and 44 in-depth interviews with purposefully selected community members (women, male, traditional birth attendants, local kebele administrators), health professionals and health extension workers (HEWs) at PHCUs. We digitally recorded, transcribed and thematically analysed the interviews and FGDs using Nvivo. The 'three delay model' informed the analytical process and discussion of barriers to the use of maternal health services. RESULTS:Lack of knowledge on danger signs and benefits of maternal health services; cultural and traditional beliefs; trust in TBAs; lack of decision making power of women, previous negative experiences with health facilities; fear of going to an unfamiliar setting; lack of privacy and perceived costs of maternal health services were the main factors causing the first delay in deciding to seek care. Transport problems in inaccessible areas were the main contributing factor for the second delay on reaching care facilities. Lack of logistic supplies and equipment, insufficient knowledge and skills and unprofessional behaviour of health workers were key factors for the third delay in accessing quality care. CONCLUSIONS:Use of maternal health services at the PHCU level in Sidama zone is influenced by complex factors within the community and health system. PHCUs should continue to implement awareness creation activities to improve knowledge of the community on complications of pregnancy and benefits of maternal health services. The health system has to be responsive to community's cultural norms and practices. The mangers of the woreda health office and health centres should take into account the available budgets; work on ensuring the necessary logistics and supplies to be in place at PHCU.

Dataset Information

Enrollment in community based health insurance program and the associated factors among households in Boricha district, Sidama Zone, Southern Ethiopia; a cross-sectional study.

Publications

Enrollment in community based health insurance program and the associated factors among households in Boricha district, Sidama Zone, Southern Ethiopia; a cross-sectional study.

Similar Datasets

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