Community-based health insurance service utilization and associated factors in Addis Ababa, Ethiopia

Abstract

Introduction: Community-based health insurance (CBHI) scheme is a powerful tool to achieve universal health service coverage by providing financial protection against healthcare costs. Ethiopia introduced CBHI, although its utilization is suspected to be poor. Consequently, this study aimed to assess CBHI service usage and related factors. Methods: Six hundred fifty-two participants were enrolled in this study. Data was collected through a face-to-face interview. Results: This study indicated that 60% of respondents utilized the CBHI service. In this study, male participants were 44% less likely to use the CBHI service (AOR = 0.44 with 95%CI: 0.28–0.70) than female participants. Besides, participants from small households were 54% less likely to utilize the CBHI service (AOR = 0.54 with 95%CI: 0.36–0. 82) than those from large families. However, using the CBHI service was 4.97 times higher among illiterate participants (AOR = 4.97 with 95%CI: 1.46–16.91) than those with literacy skills. Moreover, participants with low income were 5.14 times more likely to use the CBHI service (AOR = 5.14 with 95%CI: 2.27–11.64) than those with high monthly income. Additionally, participants who had not a private home were 6.31 times higher to use the CBHI service (AOR = 6.31 with a 95%CI: 2.76–14.46) than those who had. Furthermore, participants having adequate information on the CBHI were 8.99 times more likely to use the CBHI service (AOR = 8.99 with 95%CI: 5.66–14.27) than those who had not. Conclusion: The study provides essential information regarding CBHI service utilization and associated factors. Although the majority of the participants used the CBHI service, still a large number of users did not receive the services properly. Availability of laboratory services and delivery of essential drugs were low. Therefore, government and other relevant agencies should develop effective regulatory systems to promote the CBHI service and improve public health facilities' capacity to provide CHHI services properly.