Willingness of Households to Pay Community Based Health Insurance and its Associated Factors in Mecha District, Northwest Ethiopia: Community based Cross-sectional Study

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Abstract Background Community-based health insurance schemes helps to give financial protection and decrease direct out- of-pocket payment for health care based on the assumption of risk-pooling and community solidarity to risks of falling sick. Ethiopia is a low income country with more of health spending out of pocket payment by households. Community based health insurance was introduced in Ethiopia in 2010.It covers only the rural community and informal sector. Objectives this study aimed to assess willingness of households to pay community based health insurance and its associated factors in Mecha district, Northwest, Ethiopia. Methods Community based cross-sectional study design was used to collect data from 285 household heads using multistage sampling techniques in Mecha district Northwest Ethiopia. The data were collected by using trained data collectors and using a pre-tested structured questionnaire. A binary logistic regression model was used to determine the presence of statistically significant associations between the dependent and independent variables at p-value < 0.05 and AOR values with 95% CI. Results From the total of 296 sampled respondents, 285 participated in the study with the response rate of 96.3%. Of these, 251(88.1%) were willing to join voluntary as well as 34(11.9%) were join mandatory and 256(89.8%) of them were willing to pay community based health insurance services. The average amount of money the households were willing to pay per household per annum was 334.02 ETB found with the interval of (317.32–351.30) with the range between 240–1000 ETB. Conclusions The willingness of house hold heads to pay for the community-based health insurance was high. Residence, join CBHI, premium affordable, CBHI have an advantage and distance from households home to HF were more willing to pay CBHI schemes. The study indicated that high willing to pay and low CBHI package fulfil the needs of HH treatment as well as overall CBHI service level was poor. Therefore, Mecha district CBHI coordinating office should be scale up the community-based health insurance services in the scheme.

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