Pooling resources to pay for healthcare services and attain universal health coverage is a viable global agenda, especially for underdeveloped health systems. Ethiopia has implemented community-based health insurance (CBHI) since 2011 to improve healthcare funding. However, comprehensive evidence on the demand and determinants of health insurance in Ethiopia is lacking. Therefore, this review aimed at identifying determinants of willingness to pay (WTP) for CBHI in Ethiopia. A narrative review was conducted using search terms from PubMed, Science Direct, Scopus, African Journal Online, and Google Scholar databases. Screening process considered publication year, settings, English language, and study participants. Newcastle Ottawa tool assessed the quality of included studies. A thematic framework was applied. The review protocol was registered in PROSPERO with an ID number CRD42022296840. The review included 10 studies. The synthesis identified 25 determinants of WTP for CBHI in Ethiopia. Socio-demographic and economic, scheme-related, and health-related determinants of WTP for the CBHI were identified. Determinants of household WTP for CBHI in Ethiopia were multi-dimensional. Socio-demographic, socio-economic, scheme-related, and health-related factors are among the common determinants documented. CBHI is thus an alternative and potential source of financing for the healthcare system, primarily for people with low socioeconomic status and a fragile health system. The health system, socioeconomic leaders, and political figures play a significant role in influencing communities towards WTP for CBHI while increasing government spending on health toward UHC.
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| http://dx.doi.org/10.1016/j.pmedr.2023.102474 | DOI Listing |
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Multidimensional determinants of willingness to pay for community-based health insurance in Ethiopia and its implication towards universal health coverage: A narrative synthesis.
Prev Med Rep
December 2023
Schools of Public Health, the University of Queensland, Brisbane, Australia.
Pooling resources to pay for healthcare services and attain universal health coverage is a viable global agenda, especially for underdeveloped health systems. Ethiopia has implemented community-based health insurance (CBHI) since 2011 to improve healthcare funding. However, comprehensive evidence on the demand and determinants of health insurance in Ethiopia is lacking.
View Article and Find Full Text PDFWillingness to enroll and pay for community-based health insurance, decision motives, and associated factors among rural households in Enugu State, Southeast Nigeria.
Niger J Clin Pract
July 2023
Department of Health Administration and Management; Department of Nursing, College of Medicine, University of Nigeria, Enugu Campus, Nigeria.
Background: Over 70% of Nigeria's population is poor and rural, and most lack financial risk protection against ill health. Community-based health insurance (CBHI) may be an essential intervention strategy for ensuring that quality healthcare reaches the informal and rural populations.
Aim: This article explores the willingness to enroll (WTE) and willingness to pay (WTP) for CBHI by community members, their decision considerations, and associated factors in Enugu State, Nigeria.
Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia.
PLoS One
October 2022
Bergen Centre for Ethics and Priority Setting, Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Background: Community-based Health Insurance (CBHI) is a voluntary prepayment mechanism that guarantees the provision of basic healthcare services without financial barriers to underserved segments of the population in developing countries. The Government of Ethiopia launched the CBHI program to protect the community from high out-of-pocket health expenditure and improve health service utilization a decade ago. However, to improve the quality of healthcare services delivery in health facilities and cover the changing costs of healthcare, the government should revise the contribution of the CBHI scheme.
View Article and Find Full Text PDFWillingness to pay for community based health insurance scheme and factors associated with it among households in rural community of South West Shoa Zone, Ethiopia.
BMC Health Serv Res
June 2022
Department of Economics, Ambo University Woliso Campus, P.O.Box 217, Woliso, Ethiopia.
Background: Out-of-pocket payments are the major significant barrier in achieving universal health coverage, particularly in developing countries' rural communities. In 2011, the Ethiopian government launched a pilot community-based health insurance (CBHI) scheme with the goal of increasing access to modern health care services and providing financial security to households in the informal sector and rural areas. The main objective of this study is to estimate willingness to pay (WTP) for CBHI scheme and factors that influence it among rural households in the South West Shoa Zone.
View Article and Find Full Text PDFPotential demand for voluntary community-based health insurance improvement in rural Lao People's Democratic Republic: A randomized conjoint experiment.
PLoS One
October 2019
Graduate School for International Development and Cooperation, Hiroshima University, Higashi-hiroshima, Hiroshima, Japan.
Article Synopsis
- - In Lao PDR, community-based health insurance (CBHI) is aimed at self-employed individuals in rural areas but has struggled with low enrollment rates due to a lack of supporting components alongside health infrastructure.
- - The study analyzes how various components of hypothetical CBHI benefit packages influence enrollment probabilities and the willingness to pay (WTP) using data from a randomized experiment involving 5,800 participants.
- - Results indicate that the WTP in rural areas is noticeably higher than in other low- and middle-income countries, suggesting that the limited enrollment in the CBHI scheme may not reflect a lack of demand but rather deficiencies in the current offerings.
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