المؤلفون: Fitsum Teferi Gulta, Tidenek Mulugeta, Biruk Wogayehu, Mende Mensa

المصدر: Journal of Pharmaceutical Health Care and Sciences, Vol 10, Iss 1, Pp 1-14 (2024)

مصطلحات موضوعية: Community based health insurance, Patient satisfaction, Pharmacy services, Ethiopia, Therapeutics. Pharmacology, RM1-950, Pharmacy and materia medica, RS1-441

الوصف: Abstract Background Patient satisfaction is a crucial humanistic outcome metric in pharmacy services. There was a lack of evidence on patients’ satisfaction with pharmacy services in Gamo zone among users and nonusers of the CBHI scheme. Therefore, the aim this study is to compare the level of patient satisfaction with pharmacy services among users and nonusers of community based health insurance scheme at public health facilities in Gamo zone, South Ethiopia. Method A facility based comparative cross sectional study design with mixed approach was conducted from June 1 to 30, 2023. A total of 522 study participants and 16 key informants were included as the sample size for quantitative and qualitative study, respectively. The quantitative data was gathered from the study participants who visited the outpatient pharmacy department during the study period by using a simple random sampling technique, while the purposive sampling technique was used to select clients and key informants for the qualitative study. The adjusted odds ratio (AOR) was used to measure the association between independent variables and patient satisfaction toward outpatient pharmacy services at the P values

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2055-0294Test

الوصول الحر: https://doaj.org/article/8a298f71a58e47e0b5daed23768fb2d2Test

المؤلفون: Olkeba Begna, Habtamu Fekadu Gemede, Aboma Motuma, Tesfaye Shibiru, Temesgen Tilahun, Firew Tekle Bobo, Meseret Belete Fite

المصدر: Journal of Health, Population and Nutrition, Vol 43, Iss 1, Pp 1-7 (2024)

مصطلحات موضوعية: Household, Community-based health insurance, Nekemte city, Ethiopia, Nutritional diseases. Deficiency diseases, RC620-627, Public aspects of medicine, RA1-1270

الوصف: Abstract Introduction Ethiopia has been implementing community-based health insurance programs since 2011 to improve health care financing system. However, the prevalence of household willingness to join the community-based health insurance (CBHI) program and its associated factors are less explored in urban area. Therefore, this study was aimed to assess the prevalence of willingness to join community-based health insurance program and its associated factors among households in Nekemte City, Ethiopia. Methods A community-based cross-sectional study was conducted on 422 randomly selected households in Nekemte City, Ethiopia. Bivariate and multivariable analyses were performed to see the association between the independent and outcome variables using binary logistic regression model. Association was described using an adjusted odd ratio (AOR) and a 95% confidence interval (CI). Finally, p-value

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/2072-1315Test

الوصول الحر: https://doaj.org/article/7ac03b9e38e045c19808f0c410e0c4d1Test

المؤلفون: Kebede MM

المصدر: Risk Management and Healthcare Policy, Vol Volume 17, Pp 603-622 (2024)

مصطلحات موضوعية: health belief model, community-based health insurance, enrollment, dropout, the city of gondar peri-urban community., Public aspects of medicine, RA1-1270

الوصف: Molla Melkamu Kebede Public Administration, University of International Business and Economics, Beijing, People’s Republic of ChinaCorrespondence: Molla Melkamu Kebede, Email mollamelkamu1974@gmail.com; de202254015@uibe.edu.cnBackground: A research gap exists in finding practical solutions to provide affordable and accessible health insurance coverage to improve CBHI enrollment and sustainability to people in resource-poor settings and contribute to achieving universal health coverage (UHC) in Ethiopia. This research was initiated to analyze the role of community trust in scheme management and health choice to identify significant factors based on the health belief model (HBM). This psychological framework explains and predicts health behavior by considering individual perceptions.Methods: Cross-sectional information was gathered from 358 families, and original facts were utilized. Descriptive data and the Binary logistics in the econometric model were applied for data analysis.Findings: The descriptive findings demonstrated that other variables were established to possess a significant consequence except for job and occupation variables. The results of the logistic regression model showed that the distance of the nearest health station from the family’s home in a minute [AOR (95% CI) =0.177 (0.015, − 0.399)], being a member of the families having an official position in local government or cultural structure [AOR (95% CI) =0.574 (0.355, 0.793)], having an experience of visiting health facilities [AOR (95% CI) =0.281 (0.166, 0.396)], and perceiving the local CBHI scheme management as trustworthy [AOR (95% CI) =0.404 (0.233, 0.575)] were positively associated with family enrollment in the CBHI scheme. On the other hand, being a member of the “rotating saving and credit association” (ROSCA) [AOR (95% CI) =− .299 (− .478, − 0.120)] was negatively associated with the family’s enrollment in the CBHI scheme.Conclusion: Trust in CBHI scheme management, family’s experience of visiting health facilities, and distance from the nearest health station were essential factors influencing enrollment in CBHI schemes. “Rotating saving and credit association” (ROSCA) ° negatively and statistically significantly impacted the family’s CBHI enrolment status. Income level was not associated with enrollment.Keywords: health belief model, community-based health insurance, enrollment, dropout, the city of Gondar Peri-Urban community

وصف الملف: electronic resource

العلاقة: https://www.dovepress.com/exploring-factors-influencing-familys-enrollment-inTest-community-based-he-peer-reviewed-fulltext-article-RMHP; https://doaj.org/toc/1179-1594Test

الوصول الحر: https://doaj.org/article/2179b13cc3134a4589cae35cd231361eTest

المؤلفون: Emmanuel Otieno, Josephine Namyalo

المصدر: Journal of Preventive Medicine and Public Health, Vol 57, Iss 1, Pp 91-94 (2024)

مصطلحات موضوعية: health insurance scheme, community based health insurance, universal health coverage, uganda, Medicine, Public aspects of medicine, RA1-1270

الوصف: For nearly four decades, Ugandans have experienced a period marked by hope, conflict, and resilience across various aspects of healthcare reform. The health insurance system in Uganda lacks a legal framework and does not extend benefits to the entire population. In Uganda, community-based health insurance is common among those in the informal sector, while private medical insurance is typically provided to employees by their workplaces and agencies. The National Health Insurance Scheme Bill, introduced in 2019, was passed in 2021. If the President of Uganda gives his assent to the National Health Insurance Bill, it will become a significant policy driving health and universal health coverage. However, this bill is not without its shortcomings. In this perspective, we aim to explore the complex interplay of challenges and opportunities facing Uganda’s health sector.

وصف الملف: electronic resource

العلاقة: http://jpmph.org/upload/pdf/jpmph-23-110.pdfTest; https://doaj.org/toc/1975-8375Test; https://doaj.org/toc/2233-4521Test

الوصول الحر: https://doaj.org/article/811c8ca41967414099637f644b9a27b8Test

المؤلفون: Ashenafi Kibret Sendekie, Ayenew Hailu Gebremichael, Melkamu Workie Tadesse

المصدر: BMC Health Services Research, Vol 24, Iss 1, Pp 1-11 (2024)

مصطلحات موضوعية: Community-based health insurance, Enrollment, CBHI, Satisfaction, Ethiopia, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Although the Ethiopian government has implemented a community-based health insurance (CBHI) program, community enrollment and clients’ satisfaction have not been well investigated in Gondar Zuria district, Northwest Ethiopia. This study assessed CBHI scheme enrollment, clients’ satisfaction, and associated factors among households in the district. Methods A community-based cross-sectional survey assessed CBHI scheme enrollment and clients’ satisfaction among households in Gondar Zuria district, Northwest Ethiopia, from May to June 2022. A systematic random sampling method was used to select the study participants from eligible households. A home-to-home interview using a structured questionnaire was conducted. Data were analysed using the statistical packages for social sciences version 26. Logistic regression was used to identify variables associated with enrollment and clients’ satisfaction. A p-value < 0.05 was considered statistically significant. Results Out of 410 participants, around two-thirds (64.9%) of the participants were enrolled in the CBHI scheme. Residency status (AOR = 1.38, 95% CI: 1.02–5.32; p = 0.038), time taken to reach a health facility (AOR = 1.01, 95% CI: 1.00–1.02; p = 0.001), and household size (AOR = 0.77, 95% CI: 0.67–0.88; p < 0.001) were significantly associated with CBHI scheme enrollment. Two-thirds (66.5%) of enrolled households were dissatisfied with the overall services provided; in particular, higher proportions were dissatisfied with the availability of medication and laboratory tests (88.7%). Household size (AOR = 1.31, 95% CI: 1.01–2.24; p = 0.043) and waiting time to get healthcare services (AOR = 3.14, 95% CI: 1.01–9.97; p = 0.047) were predictors of clients’ satisfaction with the CBHI scheme services. Conclusion Although a promisingly high proportion of households were enrolled in the CBHI scheme, most of them were dissatisfied with the service. Improving waiting times to get health services, improving the availability of medications and laboratory tests, and other factors should be encouraged.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6963Test

الوصول الحر: https://doaj.org/article/5c2d3b221d1045a1972f9b9de7d9deacTest

المؤلفون: Yonas Abebe, Fanuel Belayneh

المصدر: BMC Health Services Research, Vol 23, Iss 1, Pp 1-10 (2023)

مصطلحات موضوعية: Willingness, Community-based health insurance, Rural households, Gombora District, Ethiopia, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Community-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. Methods Using 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. Results The 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. Conclusion Households’ 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.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1472-6963Test

الوصول الحر: https://doaj.org/article/5c878dc49fef4e59a545903634067f28Test

المؤلفون: Husien Nurahmed Toleha, Ewunetie Mekashaw Bayked

المصدر: BMC Public Health, Vol 23, Iss 1, Pp 1-16 (2023)

مصطلحات موضوعية: Dropout rate, Renewal Rate, Community-based Health Insurance, Associated factors, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Ethiopia aims to achieve universal healthcare using health insurance. To do so, it has been implementing community-based health insurance since 2011. However, the retention of members by the scheme has not yet been evaluated nationally. The systematic review and meta-analysis aimed to evaluate the dropout rate and associated factors among the scheme’s beneficiaries in Ethiopia. Methods On December 19, 2022, searches were conducted in Scopus, Hinari, PubMed, Semantic Scholar, and Google Scholar. Searches were also conducted on the general web and electronic repositories, including the Ethiopian Health Insurance Service, the International Institute for Primary Health Care-Ethiopia, and various higher education institutions. The Joanna Briggs Institute’s tools and the “preferred reporting items for systematic reviews and meta-analyses 2020 statement” were used to evaluate bias and frame the review, respectively. Data were analyzed using Stata 17 and RevMan 5. To assess heterogeneity, we conducted subgroup analysis and used a random model to calculate odds ratios with a p value less than 0.05 and a 95% CI. Results In total, 14 articles were included in the qualitative synthesis, of which 12 were selected for the quantitative analysis. The pooled estimate revealed that the dropout rate of beneficiaries from the scheme was 34.0% (95% CI: 23-44%), provided that the renewal rate was 66.0%, and was found to be influenced by socio-demographic, health status, length of enrolment, knowledge, attitude, the scheme, and health service-related variables. The southern and Oromia regions reported the lowest and highest dropout rates, with 27.0% (95% CI: 24-29%) and 48.0% (95% CI: 18-78%), respectively. The dropout rates increased from 12.3% in 2012–2015 to 34.4% in 2020–2021. Conclusion More than one-third of the scheme’s beneficiaries were found to have dropped out, and this has been found to increase over time, dictating that a community-based strategy and intervention, from the supply, insurer, and demand sides, seem indispensable in minimizing this huge dropout rate.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/5a067f006b0c435796df13b2cdf738f2Test

المؤلفون: Alphoncina Kagaigai, Amani Anaeli, Sverre Grepperud, Amani Thomas Mori

المصدر: BMC Public Health, Vol 23, Iss 1, Pp 1-13 (2023)

مصطلحات موضوعية: Tanzania, Catastrophic health expenditure, Community-based health insurance scheme, Cross-sectional household survey, Out-of-pocket expenditure, Concentration index, Public aspects of medicine, RA1-1270

الوصف: Abstract Background Over 150 million people, mostly from low and middle-income countries (LMICs) suffer from catastrophic health expenditure (CHE) every year because of high out-of-pocket (OOP) payments. In Tanzania, OOP payments account for about a quarter of the total health expenditure. This paper compares healthcare utilization and the incidence of CHE among improved Community Health Fund (iCHF) members and non-members in central Tanzania. Methods A survey was conducted in 722 households in Bahi and Chamwino districts in Dodoma region. CHE was defined as a household health expenditure exceeding 40% of total non-food expenditure (capacity to pay). Concentration index (CI) and logistic regression were used to assess the socioeconomic inequalities in the distribution of healthcare utilization and the association between CHE and iCHF enrollment status, respectively. Results 50% of the members and 29% of the non-members utilized outpatient care in the previous month, while 19% (members) and 15% (non-members) utilized inpatient care in the previous twelve months. The degree of inequality for utilization of inpatient care was higher (insured, CI = 0.38; noninsured CI = 0.29) than for outpatient care (insured, CI = 0.09; noninsured CI = 0.16). Overall, 15% of the households experienced CHE, however, when disaggregated by enrollment status, the incidence of CHE was 13% and 15% among members and non-members, respectively. The odds of iCHF-members incurring CHE were 0.4 times less compared to non-members (OR = 0.41, 95%CI: 0.27–0.63). The key determinants of CHE were iCHF enrollment status, health status, socioeconomic status, chronic illness, and the utilization of inpatient and outpatient care. Conclusion The utilization of healthcare services was higher while the incidence of CHE was lower among households enrolled in the iCHF insurance scheme relative to those not enrolled. More studies are needed to establish the reasons for the relatively high incidence of CHE among iCHF members and the low degree of healthcare utilization among households with low socioeconomic status.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1471-2458Test

الوصول الحر: https://doaj.org/article/10285ce95446442cb87d4f68be01deb5Test

المؤلفون: Alphoncina Kagaigai, Amani Thomas Mori, Amani Anaeli, Sverre Grepperud

المصدر: Health Policy Open, Vol 4, Iss , Pp 100097- (2023)

مصطلحات موضوعية: Community-Based Health Insurance Schemes (CBHIs), Voluntary health insurance, Drop-outs, Enrolment decision, Multinomial regression, Public aspects of medicine, RA1-1270

الوصف: Lower-middle income countries (LMICs) have invested significant effort into expanding insurance coverage as a means of improving access to health care. However, it has proven challenging to fulfill these ambitions. This study investigates to what extent variables associated with the enrollment decision (stay never-insured or enroll) differ from variables associated with the dropout decision (stay insured or drop out). A cross-sectional survey that included 722 households from rural districts in Tanzania was conducted and multinomial logistic regressions were performed to determine the associations between independent variables and membership status (never-insured, dropouts, or currently insured). Both the decision to enrollment and the decision to drop out were significantly associated with the presence of chronic disease and perceptions about the quality of services provided, insurance scheme management, and traditional healers. The effect of other variables, such as age, gender and educational level of the household head, household income, and perceptions about premium affordability and benefit-premium ratios, varied across the two groups. To improve voluntary health insurance coverage, policymakers must simultaneously increase the enrollment rate among the never-insured and reduce the dropout rate among the insured. Our conclusions suggest that policies to increase insurance scheme enrollment rates should differ for the two uninsured groups.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S2590229623000096Test; https://doaj.org/toc/2590-2296Test

الوصول الحر: https://doaj.org/article/e13795d44a254bcdadf528660d4893f4Test

المؤلفون: Getachew Ossabo Babore, Taye Mezigebu Ashine, Asnakech Zekiwos Heliso, Teshome Tesfaye Habebo

المصدر: Frontiers in Health Services, Vol 3 (2023)

مصطلحات موضوعية: community-based health insurance, client satisfaction, enrolled, health facilities, Ethiopia, Medicine

الوصف: BackgroundGlobally, 1.3 billion poor people have no access to health services due to their inability to afford payment when they need services. According to a report published by the WHO in 2014, globally 150 million people are pushed into poverty as a result of direct payment for health services.ObjectiveThis study aims to assess the satisfaction level of clients and associated factors toward health services provided to members of a community-based health insurance (CBHI) scheme.MethodsAn institutional-based cross-sectional study design was employed. A total sample size of 393 people was estimated using a single population formula, and three health facilities (HFs) were selected using a simple random sampling method, whereas study participants were selected by using a systematic sampling method. All patients who visited the HFs were included, whereas women who visited the HFs for maternity service were excluded from the study. A reliability test (Cronbach’s alpha) was performed to determine the internal consistency for these items to measure the satisfaction level of the clients. Epi Info software version 7 was used to calculate the sample size and to enter data, whereas further data cleaning and analysis were conducted using SPSS software version 20.ResultsA total of 367 clients enrolled in the community-based health insurance scheme were interviewed, showing a response rate of 93%. The reliability test (Cronbach's alpha) value for the items used to measure level of client satisfaction was 0.817. The overall level of the clients’ mean satisfaction toward health service provision was 63.1% (3.95 + 0.47 SD). This study found that age with AOR = 0.11 [95% CI (0.01–0.79)], residence with AOR = 1.80 [95% CI (1.79–3.66)], number of family with AOR = 2.27 [95% CI (1.46–11.22)], frequency of visits to HFs with AOR = 13.62 [95% CI (2.09–88.58)], and clients’ level of knowledge with AOR = 3.33 [95% CI (1.06–10.42) had a statistical significant association with client satisfaction toward health service provision.ConclusionOur study found that the perceived level of client satisfaction is higher than previous studies. Residence, frequency of visits, level of knowledge, payment during referral time, number of family members, and frequency of visits were identified as predictors of client satisfaction on the health service provision.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/frhs.2023.1237895/fullTest; https://doaj.org/toc/2813-0146Test

الوصول الحر: https://doaj.org/article/0c69f6558a284b2db86de277c7a21318Test