Willingness to Join Community-Based Health Insurance among Rural Households of Bugna District, Northeast Ethiopia

Background: Developing countries contribute only 20 % of gross domestic product and 12 % of health spending for the world economy. Little studies done in Ethiopia indicated that the level of willingness to join the community-based health insurance among households was not more than 80% in most parts of the country. Since the program was not yet started in the study area, knowing the level of willingness had a paramount importance for smooth initiation of the scheme in the district. Therefore, this study aimed to assess the willingness to join community-based health insurance and associated factors among rural households of Bugina district, Northeast Ethiopia.

Methods: A community based cross-sectional study was conducted among households of Bugna district from February to March, 2016. The total sample size for the study was 541. Households were selected using multistage systematic sampling technique. Binary logistic regression model was used for analysis. Adjusted Odds Ratio (AOR) with 95% CI and p-value <0.05 were used to identify significantly associated variables.

Result: A total of 532 households participated in the study with a response rate of 98.3%. The finding indicates that 77.8% of the households were willing to join the scheme. The odds of participants willing to join the scheme among respondents who had attended formal education (AOR=4.35; 95% CI:1.88, 10.01), history of illness in the past three months (AOR=3.46; 95% CI:2.02, 5.94), more than five family members in the household (AOR=2.2; 95% CI:1.33, 3.70), good awareness (AOR=2.71; 95% CI1.21, 6.05) and high wealth class (AOR=4.5; 95% CI:2.26, 8.92) were higher than the odds of willing to join the scheme compared to their counterparts.

Conclusion: Willingness to join the scheme was low compared to that of other studies in the country in order to achieve the targets for universal health coverage. Therefore, the government should subside some amount of premium to the poor members, and enhancing community awareness about the scheme can enhance its uptake. It is better if the premium load may consider the family size, wealth status and health status of the households.