Community-Based Health Insurance and Associated Factors in North-Western Ethiopia. The Case of Bahir Dar City

Figures & data

Table 1 Socio-Demographic and Health-Related Characteristics

Variables	Characteristics	Frequency	Percent
Sex	Male	165	50.8
	Female	160	49.2
Age	18–24	37	11.4
	25–32	123	37.8
	33–39	85	26.2
	≥40	80	24.6
Religion	Orthodox	267	82.2
	Muslim	45	13.8
	Protestant	13	4.0
Educational status	No formal education	63	19.4
	Primary education	60	18.5
	Secondary education	58	17.8
	College and above	144	44.3
Marital status	Single	92	28.3
	Married	197	60.6
	Divorced	36	11.1
Occupation	Merchant	63	19.4
	Farmer	7	2.1
	Daily laborer	129	39.7
	Others^#	126	38.8
Monthly income (birr)	< 1500	107	32.9
	1500–10,000	202	62.2
	> 10,000	16	4.9
History of previous illness	Yes	306	94
	No	19	6
Time to the last illness	Before one month	107	32.9
	Before three months	91	28.0
	Three months ago	108	33.2
	I am not feeling sick at all	19	5.8
The measure took when they feel sick	Go to doctor	277	90.5
	Take herbal medicine	13	4.2
	Treat my self	11	3.6
	Go to a religious place	5	1.6
Need medical care in a year	Once in a year	223	68.6
	Once in three months	69	21.2
	Once in six months	33	10.2
Have you ever been admitted to the hospital	Yes	203	62.5
	No	122	37.5
Worry about paying when get sick	Yes	219	67.4
	No	106	32.6

Note: Other^# (student, housewife).

Table 2 Knowledge Assessing Characteristics of the Respondents

Variables	Category	Frequency	Percent
Have you ever heard CBHI	Yes	272	83.7
	No	53	16.3
Source of information on CBHI	Family	152	46.8
	Television	89	27.4
	Friends	49	15.1
	Magazine	35	10.8
Are you aware of the benefits package of CBHI	Yes	165	50.8
	No	160	49.2
The community-based health insurance scheme will pay for your medical expenses when you get sick	True	146	44.9
	False	139	42.8
	I am not sure	40	12.3
The CBHI scheme will cover the health care services gained by the formally employed and not employed households once joined to the CBHI scheme	True	148	45.5
	False	84	25.8
	I am not sure	93	28.6
Both the rich and the poor will receive proper healthcare of the same quality without catastrophic medical cost when becoming a member of the CBHI scheme	True	202	62.2
	False	50	15.4
	I am not sure	73	22.5
The quality of healthcare services will be almost the same throughout the whole country once the country implemented the community based-health insurance	True	142	43.7
	False	71	21.8
	I am not sure	112	34.5
You will receive services from the referred contracted higher health facilities with no out of pocket money when your health is needing a specialized health care setup.	True	121	37.2
	False	46	14.2
	I am not sure	158	48.6
The community-based health insurance covers the cost of pharmaceutical care and diagnostic tests for referred cases	True	100	30.8
	False	78	24.0
	I am not sure	147	45.2
The community-based health insurance scheme excludes treatment abroad, kidney dialysis/treatments, artificial teeth, and plastic surgery	True	128	39.4
	False	69	21.2
	I am not sure	128	39.4
The community-based health insurance scheme pays for the services received from only governmental health institutions	True	48	14.8
	False	121	37.2
	I am not sure	156	48.0
Allow people to have equal/fair access to skilled health professionals and/to finance for health care	True	192	59.1
	False	52	16.0
	I am not sure	81	24.9

Table 3 Attitude Assessing Characteristics of the Respondents

Variables	Category
	Agree N (%)	No Opinion N (%)	Disagree N (%)
Community based health insurance has the potential of on promoting healthcare seeking behavior from modern health care institutions	220 (67.7)	49 (15.1)	56 (17.2)
Community based health insurance protects from unaffordable healthcare expenditures	270 (83.1)	16 (4.9)	39 (12)
Premium payment for community-based health insurance scheme is expensive	51 (15.7)	38 (11.7)	236 (72.6)
Community-based health insurance is a means of collecting revenue (profit) to the government	43 (13.2)	75 (23.1)	207 (63.7)
Community based health insurance scheme members receive low quality of services than non-members	55 (16.9)	20 (6.2)	250 (76.9)
Mistreatment of patients by the health professionals is common for members than non-members	53 (16.3)	77 (23.7)	195 (60)
I did not have trust in management and administration of community-based health insurance scheme	108 (33.2)	51 (15.7)	166 (51.1)
Community-based health insurance is relevant only to promote health condition of the poor	142 (43.7)	70 (21.5)	113 (34.8)
Health insurance is good to pool the risk of health expenditures within the sick and the healthy	179 (55.1)	41 (12.6)	105 (32.3)
Health insurance should be advocated and scale up to improve the health condition of rural community	234 (72)	20 (6.2)	71 (21.8)

Table 4 Factors Associated with Knowledge of Community-Based Health Insurance Among Bahir Dar City Informal Workers

Variables	Knowledge of CBHI		COR (95% CI)	AOR (95% CI)
	Poor	Good
Sex
Male	65	100	1.00	1.00
Female	93	67	0.468 (0.30, 0.73)	1.67 (0.99, 2.79)
Education
No formal education	35	28	1.00	1.00
Primary	33	27	1.023 (0.50, 2.08)	1.191 (0.54, 2.64)
Secondary	46	12	1.326 (1.15,1.73)	1.29 (1.12, 1.71)*
College and above	44	100	2.841 (1.54, 5.23)	1.64 (0.74, 3.63)
Marital status
Single	35	57	4.234 (1.82, 9.82)	3.436 (1.30, 9.02) *
Married	97	100	2.680 (1.23, 5.85)	2.357 (0.97, 5.71)
Divorced	26	10	1.00	1.00
Occupation
Merchant	38	25	1.10 (0.59,2.06)	1.195 (0.59, 2.38)
Farmer	2	5	4.20 (0.78, 22.52)	3.376 (0.59, 19.17)
Daily laborer	39	90	3.879 (2.30, 6.53)	2.73 (1.36, 5.48) **
Other ^#	79	47	1.00	1.00
Source of Information
Television	55	34	0.39 (0.19,0.80)	0.31 (0.14, 0.71) **
Magazine	17	18	0.67 (0.28,1.61)	0.57 (0.20, 1.56)
Family	67	85	0.80 (0.42,1.55)	0.77 (0.37, 1.65)
Friends	19	30	1.00	1.00
Age
15–24	17	20	0.83 (0.40,1.75)	0.61 (0.19,1.92)
25–34	62	61	0.76 (0.35,1.64)	0.49 (0.23,1.06)
35–44	45	40	1.15 (0.52,2.52)	0.67 (0.32,1.41)
≥45	34	46	1.00	1.00

Notes: Other^# (student, housewife); P-value * < 0. 05, ** < 0. 01.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio.

Table 5 Factors Associated with Attitude Towards Community-Based Health Insurance Among Bahir Dar City Informal Workers

Variables	Attitude Towards CBHI		COR (95% CI)	AOR (95% CI)
	Unfavorable	Favorable
Sex
Male	83	82	1.00	1.00
Female	61	99	1.64 (1.05,2.55)	0.61 (0.36,1.03)
Education
No formal education	42	21	0.31 (0.16,0 0.57)	0.49 (0.19, 1.21)
Primary	30	30	0.61 (0.34, 1.13)	0.78 (0.34, 1.77)
Secondary	17	41	1.49 (1.77,2.87)	2.04 (1.91, 4.56)*
College and above	55	89	1.00	1.00
Marital status
Single	42	50	0.34 (0.14, 0.82)	0.23 (0.08, 0.67)**
Married	94	103	0.31 (0.13, 0.72)	0.29 (0.11,0.73)**
Divorced	8	28	1.00	1.00
Occupation
Merchant	30	33	1.33 (0.73,2.44)	1.16 (0.58, 2.35)
Farmer	1	6	7.26 (0.85, 62.1)	3.33 (0.59,18.71)
Daily laborer	44	85	2.33 (1.41, 3.87)	2.84 (1.37. 5.88)*
Other^#	69	57	1.00	1.00
Source of Information
Television	33	56	3.500 (1.67, 7.3)	3.09 (1.37, 6.93)**
Magazine	18	17	1.94 (0.79, 4.75)	1.51 (0.55, 4.15)
Family	60	92	3.16 (1.60, 6.24)	2.63 (1.23, 5.61)*
Friends	33	16	1.00	1.00
Age
15–24	11	26	3.04 (1.32, 6.98)	1.85 (0.61, 5.59)
25–34	49	74	1.94 (1.09, 3.43)	0.98 (0.48, 2.01)
35–44	39	46	1.51 (0.82, 2.80)	0.80 (0.39, 1.65)
≥45	45	35	1.00	1.00
Knowledge status
Poor	62	96	1.49 (0.962, 2.32)	1
Good	82	85	1.00	1

Notes: Other^# (student, housewife); P-value * < 0. 05, ** < 0. 01.

Abbreviations: COR, crude odds ratio; AOR, adjusted odds ratio.