Investigation of Moral Hazard Deportments in Community-Based Health Insurance in Guto Gida District, Western Ethiopia: A Qualitative Study

Abstract

Introduction

Ethiopia introduced CBHI in 2011 as part of the health sector finance improvement. This study was accompanied to identify moral hazard behaviors in community-based health insurance in Guto Gida District of Oromia regional state.

Methods

The qualitative study used data generated from focus group discussions and in-depth interviews. Three health service centers were purposively selected for the study. Thematic analysis was accomplished using the NVivo-12 software package as it operates better in qualitative data analysis.

Results

The study found that member’s frequent visit to health service centers, tendency to collect more drugs, sense of feeling cheated by the insurance, tendency to use their cards redundantly, giving their cards to nonmembers, and seeking for most often expensive drugs were the demand side moral hazard behaviors explored by the study. From the supply side, inflating the price of drugs, increasing the price of services, alleging for services not provided, overstating the number of customers obtained insurance package and insulting users are found as moral hazard problems.

Conclusion

The study concluded that moral hazard behavior is discouraging from both the demand and supply sides. The presence of moral hazard discourages members of CBHI and creates reluctances in the scheme officials and workers. The policy implication is that tremendous attention should be given to reducing the level of moral hazard behaviors from the sides of both users and providers.

Keywords:

• moral hazard deportments
• CBHI
• qualitative study
• Guto Gida
• Western Ethiopia

Abbreviations

CBHI, community based health Insurance; CSA, Central Statistical Agency-Ethiopia; FDG, focus group discussions, FDMOH, Federal Ministry of Health–Ethiopia; IDI, in-depth Interview; WHO, World Health Organization.

Ethics and Consent Statement

Informed consent to take part in the study was received from the participants including publication of their anonymized responses. This study was also conducted following the Declaration of Helsinki.

Acknowledgment

I would also like to express my sincere gratitude and appreciation to Melkamu Wolde and Firdissa Sadeta for their critic and valuable contribution to this work. Frankly speaking, this paper may not be as smart as it is without the unreserved follow up and supervision by those excellences.

Disclosure

The author reports no conflict of interest in any form or shape. The author has decided to work on this article to contribute to the body of knowledge in health economics and business sciences. Thus, this article is purely a scholarly work for advancement academics.