Abstract:
Background: The government of Ethiopia initiated social health insurance to be applied first
on formal employer with compulsory membership of the system and the members will get
health service from a health facility contracted by the Ethiopian health insurance agency by
paying a monthly premium. The support of social health insurance by all stakeholders including
civil servants will help for success and sustainability of the program. This study will provide
the prevalence of support towards the proposed social health insurance among civil servants in
Gulele sub city.
Objective: The aim of this study was to assess civil servants’ of support and its associated
factors on the proposed social health insurance scheme in Gulele sub-city.
Methods: A cross sectional study was carried out from April to June 2014 in three woredas of
Gulele sub city. A cluster sampling method was used based on available woredas in the sub
cities to select the three woredas randomly. Data on civil servants level of support towards the
proposed SHI were collected using self-administered questionnaire then entered, checked and
cleaned by EPI data version 3.1 and exported to SPSS version 20 for analysis. Descriptive,
bivariate and multivariate analyses were performed.
Result: six hundred twenty eight civil servants working in three woredas of Gulele sub city
were enrolled in this study. The overall level of support towards the proposed social health
insurance scheme in Gulele sub-city was 35.8%. Willingness to risk cross-subsidies, level of
awareness towards the scheme, preference of health facility to utilize, perceived cost and
benefit of the proposed social health insurance were influencing factors for support towards the
proposed SHI (. Those willing to cross subsidies health risks and prefer to utilize governmental
health facility were seven and five times likely to give support for the proposed social health
insurance scheme (AOR=7[2.8-16.78] and AOR=5[2.02-12.74] ) ,respectively.
Conclusion and recommendation. The study shows there was low support towards the
proposed SHI among civil servants working in Gulele sub-city. More effort should be done to
increase the support toward the proposed social health insurance among the civil servants,
which includes involvement of private health facilities as health care provider of the scheme.
