Assessment of readiness of public health facilities to implement community based health insurance and social health insurance schemes in Jimma Zone, southwest Ethiop

Abstract

Background: In response to the 2005 World Health Assembly, many developing countries of the world developed different risk pooling/prepayment mechanisms to ensure universal coverage of health services. Readiness of the health system to bear the responsibility of providing health services for all who are part of the insurance schemes is of critical importance. Objectives: The objective of this study was to assess readiness of public health facilities to implement community based health insurance and social health insurance schemes. Methods: A facility based quantitative cross sectional study complemented with qualitative methods was conducted in Jimma Zone. Six weredas of the 18 weredas were included in the study; and a total of 21 health facilities were selected out of 36 by lottery method. Data was collected by structured and interviewer administered questionnaire, and supplemented by observation. The collected data was analyzed by SPSS version 20.0 by doing descriptive statistics. The observation data supported the interviews data. Results: Among a total 21 health facilities surveyed only 38.1% had all health professionals compared against the national standards. Mean and standard deviation of availability of basic amenities were 5.48 and 1.436 respectively. The availability of basic equipment was found to be below 75% of benchmarks in 14.8% of surveyed facilities. The availability of infection prevention supplies were found to be below 75% of 13 benchmarks selected in majority of facilities 52.3%. The availability of laboratory services were found to be below 75% of all (12) selected services in 90.4% of facilities. Mean and standard deviation of availability of essential medicines were 9.9 and 1.947 respectively. All of the surveyed facilities had governing board, 95.2% had management committee, 71.4% were informed about health insurances implementation and only 4.8% of facilities had unit/departments to coordinate health insurance schemes. All rates of availability were confirmed/ cross-checked by observations. Conclusion: According to the findings in this study it is possible to conclude that the degree of readiness of the health facilities to bear the responsibility of providing services to all who will enroll in the insurance schemes is very low. Therefore, the concerned body must take immediate measure to improve the degree of readiness of public health facilities by equipping and staffing all health facilities as per the standards for effective implementation of the health insurances schemes.