Level of household’s head satisfaction and associated factors towards Community-Based Health Insurance (CBHI) schemes among enrollees in Northwest Ethiopia. A community- based cross-sectional study

Abstract

Background: The level of household heads’ satisfaction with community-based health insurance schemes is more likely to affect their decision to remain enrolled and the entrance of new members. However, studies regarding household heads’ satisfaction with the community-based health insurance schemes are scarce in Ethiopia. Therefore, this study aimed to determine the level of satisfaction with a community-based health insurance schemes and associated factors among heads of households in Northwest Ethiopia. Methods: A community-based cross-sectional study was conducted from March 1-30, 2022. A systematic random sampling technique with multi-stage sampling was used to select 604 study participants. A face-to-face interview was conducted using a pre-tested structured questionnaire. Both bivariable and multivariable logistic regression analyses were conducted. An Adjusted Odds Ratio (AOR) with 95% Confidence Intervals (CI) was computed to evaluate the strength of the association, and variables with a p-value <0.05 at a 95% confidence interval were considered statistically significant. Results: This study found that about 56.1% of household heads’ were satisfied with the CBHI schemes. Being older age (AOR=1.85; 95% CI: 1.17, 2.94), rural residence (AOR=4.13; 95% C.I: 2.24, 7.62), visited only health center (AOR=0.34; 95% CI: 0.20, 0.55), distance from a health facility (AOR=3.18; 95% CI: 1.82, 5.55), agreement with prescribed drugs (AOR=2.31; 95% CI: 1.36, 3.92), friendliness with healthcare provider (AOR=3.65; 95% CI: 2.18, 6.10), and had a good knowledge of benefit packages (AOR=3.00; 95% CI: 1.93, 4.67) were significantly associated with household head satisfaction. Conclusion: The overall satisfaction of households' heads with the CBHI schemes was good. Age, residence, type of health facility visited, distance from health facilities, friendliness with healthcare providers, agreement with prescribed drugs, and knowledge of CBHI benefit packages were statistically significant predictors of satisfaction. Further study is needed using a strong study design or a mixed qualitative and quantitative approach.