Exploring Factors Influencing Family’s Membership in Community-Based Health Insurance in the City of Gondar Peri-Urban Area, Northwest Ethiopia: A Health Belief Model Approach

Abstract

Abstract Background- A research gap exists in finding practical solutions to provide affordable and accessible health insurance coverage to improve CBHI membership 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 health choice to identify significant factors based on the health belief model (HBM) by providing a theoretical framework for understanding individual health-related behavior and developing effective interventions to promote participation in health insurance programs. Methods- Cross-sectional information was gathered from 358 families, and original facts were utilized. Descriptive and Binary logistics in the econometric model were applied for data analysis. Findings- The descriptive findings demonstrated that except for sex, religion, nuclear family largeness, and job occupation variables, other variables established a significant Consequence. 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) = .177 (.015, − .399)], being a member of the families having an official position in local government or cultural structure [AOR (95% CI) = .574 (.355, .793)], having an experience of visiting health facilities [AOR (95% CI) = .281 (.166, .396)], and perceiving the local CBHI scheme management as trustworthy [AOR (95% CI) = .404 (.233, .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, − .120)] was negatively associated with the family’s enrollment in the CBHI scheme. Conclusion- Institutional variables, trust in CBHI scheme management, and family’s experience of visiting health facilities and distance from the nearest health station were essential factors influencing enrollment, whereas “Rotating saving and credit association” (ROSCA) º negatively and statistically significantly impacted and income level was not associated with membership.