Willingness to Pay for Social Health Insurance Among Health Care Professionals in North Wollo Zone, Amhara Region, Ethiopia: Mixed Method Study

Figures & data

Figure 1 Schematic presentation of sampling procedure in North Wollo zone.

Abbreviations: HO, Health office; HC, Health center.

Table 1 Socio-Demographic Characteristics of Health Professionals in North Wollo Zone, Ethiopia, June 2022

Study Variables		N (%)
Gender	Male	312 (53.1)
	Female	276 (46.9)
Age (years)	< 30	222 (37.8)
	30–40	286 (48.6)
	≥ 41	80 (13.6)
Marital status	Married	372 (63.3)
	Currently single	216 (36.7)
Educational status	Diploma	266 (45.2)
	First degree	266 (45.2)
	Master’s degree and above	56 (9.5)
Monthly salary in ETB (1 USD = 51.84 ETB)	≤ 7430	288 (49.0)
	7431–9490	226 (38.4)
	> 9491	74 (12.6)
Family size	≤ 3	326 (55.4)
	4–6	244 (41.5)
	≥ 7	18 (3.1)
Presence of under five years children	Yes	432 (73.5)
	No	156 (26.5)

Abbreviation: ETB, Ethiopian Birr.

Table 2 Health Status and Health-Related Characteristics of Health Professionals in North Wollo Zone, Ethiopia, June 2022

Variables	Response	N (%)
Presence of chronic illness among family members (n = 588)	Yes	84 (14.3)
	No	504 (85.7)
Presence of any illness during the last 12 months (n = 588)	Yes	208 (35.4)
	No	380 (64.6)
Seeking treatment for the recent episode of illness (n = 208)	Yes	200 (96.2)
	No	8 (3.8)
Place of treatment sought (n = 200)	Public health facility	148 (74.0)
	Private health facility	35 (17.5)
	Community pharmacy	17 (8.5)
Source of health expenditure (n = 200)	OOP	52 (26.0)
	Employer	148 (74.0)
Satisfaction with quality of services at public health facilities (n = 148)	Satisfied	33 (22.3)
	Neutral	46 (31.1)
	Not satisfied	69 (46.6)

Abbreviation: OOP, Out-of-pocket.

Table 3 Awareness of Social Health Insurance Schemes Among Health Professionals in North Wollo Zone, Ethiopia, June 2022

Descriptions	Response	N (%)
Ever heard of the social health insurance scheme (n=588)	Yes	588 (100)
	No	–
Source of information for SHI scheme (n=588)*	Mass media	182 (30.9)
	Family	96 (16.3)
	Friends	250 (42.5)
	Insurance agency	68 (11.6)
Believe that SHI has benefits (n = 588)	Yes	578 (98.3)
	No	10 (1.7)
Benefit of SHI scheme (n = 578)*	Prevent unexpected health expenditure	331 (57.3)
	Help others who cannot afford their medical cost	127 (22.0)
	Have timely care in times of illness	90 (15.6)
	Improve health services quality	64 (11.1)
Information on the source of finance for SHI(n = 578)*	Members’ contribution	565 (97.7)
	Employers’ contribution	25 (4.3)
	Investment Income	17 (2.9)

Note: *Multiple responses is possible.

Abbreviation: SHI, social health insurance.

Figure 2 Willingness to pay for SHI among healthcare professionals of North Wollo zone, Ethiopia.

Table 4 Reasons for Willingness/Unwillingness to Pay for Social Health Insurance

Variables	N (%)
Reasons for WTP for SHI
Provides free access to medical care at the point of service	206 (51.0)
Financial security in times of ill health	120 (29.7)
Helping others who cannot afford their medical bills	58 (14.4)
Facing frequently ill	20 (5.0)
Reasons for not joining SHI
Government should cover the cost	96 (52.2)
Double payment wife and husband	36 (19.6)
Preferring OOP	30 (16.3)
SHI scheme does not cover all the health care costs	14 (7.6)
Healthcare providers lost interest in paying for SHI	6 (3.0)
Poor quality of health service	2 (1.1)

Abbreviations: OPP, Out-of-pocket; SHI, Social health insurance; WTP, Willingness to pay.

Table 5 Factors Associated with WTP for SHI Among Health Professionals in North Wollo Zone, Ethiopia, June 2022

Study Variables		WTP for SHI		COR (95% CI)	AOR (95% CI)
		Yes (%)	No (%)
Gender	Male	204 (65.4)	108 (34.6)	1	1
	Female	200 (72.5)	76 (27.8)	0.718 (0.505–1.021)*	0.426 (0.196–0.926)*
Age (years)	< 30	165 (73.7)	59 (26.3)	1	1
	30–40	80 (62.5)	48 (37.5)	1.354 (0.905–2.027)	0 0.935 (0.229–3.817)
	≥ 41	159 (67.4)	77 (32.6)	0.807 (0.515–1.265)	0.692 (0.223–2.143)
Marital status	Married	274 (73.7)	98 (26.3)	1	1
	Currently single	130 (60.2)	86 (39.8)	1.85 (1.294–2.643)	0.706 (0.257–1.937)
Educational status	Diploma	204 (76.7)	62 (23.3)	1	1
	First degree	182 (68.4)	84 (31.6)	6.946 (3.704–13.026)	1.0970 (0.430–2.796)
	Master’s degree and above	18 (32.1)	38 (67.9)	4.574 (2.467–8.482)	0.346 (0.087–1.380)
Monthly salary in ETB (1 USD = 51.84 ETB)	≤ 7430	232 (80.5)	56 (19.5)	1	1
	7431–9490	142 (62.8)	84 (37.2)	6.076 (3.512–10.513)*	0.643 (0.281–1.473)*
	> 9490	30 (40.5)	44 (59.5)	2.479 (1.449–4.241)*	0.164 (0.056–0.478)*
Presence of under five years children	Yes	314 (72.7)	118 (27.3)	1.951 (1.332–2.858)*	2.790 (1.026–7.587)*
	No	90 (57.7)	66 (42.3)	1	1
Presence of chronic illness among family members	Yes	238 (74.4)	82 (25.6)	1.783 (1.254–2.535)*	0.389 (0.102–1.476)
	No	166 (61.9)	102 (38.1)	1	1
Place of treatment sought	Public health facility	121 (81.7)	27 (18.3)	1	1
	Private health facility	30 (85.7)	5 (14.3)	1.339 (0.476–3.767)	1.122 (0.224–5.614)
	Community pharmacy	158 (79.0)	42 (21.0)	0.156 (0.055–0.447)	0.001 (0.000–0.025)
Source of health expenditure	Out of pocket	37 (71.1)	15 (28.9)	1	1
	Employer	121 (85.2)	21 (14.8)	0.550 (0.265–1.143)*	1.991 (0.894–4.437)
Satisfaction with quality of services at public health facilities	Satisfied	352 (69.0)	158 (31.0)	1	1
	Neutral	22 (78.6)	6 (21.4)	1.646 (0.655–4.138)	0.504 (0.131–1.943)
	Not satisfied	30 (60.0)	20 (40.0)	0.673 (0.371–1.222)	6.42 (1.241–33.288)

Note: *Significant at p < 0.05.

Abbreviations: AOR, Adjusted odds ratio; COR, Crude odds ratio; CI, Confidence interval; SHI, Social health insurance; WTP, Willingness to pay.

Data Sharing Statement

All relevant data are within the paper.