Determinants of Community Based Health Insurance Participation Evidence from Informal Sector Workers in Limu Kossa District of Jimma Zone, Ethiopia

Abstract

Community based health insurance(CBHI) is the strategic variable in mitigating risk of direct out of pocket spending in the case of health shocks and indirect economic costs affecting both individual and national wellbeing. However, household heads participation in Ethiopia CBHI pilot districts is limited and little is known empirically about its factors. This study was initiated with the objective of identifying major factors affecting informal sector workers participation in community based health insurance. For the purpose of the study a cross sectional data were collected from 396 sample households and primary data was used. Interview schedule was used to collect primary data from the sampled households. For the purpose of data analysis, descriptive statistics and Binary logit econometric model were used. From the Binary logit results, six variables namely; age of household head’s, household head’s educational status, annual expenditure, having information about the scheme and being member in local cooperatives of the household heads were found to have a positively significant effect on the informal sector workers decision to participate in CBHI while distance from the nearest health center was found to have a negatively significant effect on the informal sector workers decision to participate in community based health insurance. Based on these findings, the researcher recommended that emphasis should be given towards strengthening formal and non-formal educational opportunities, health sectors and CBHI agencies in collaboration with other concerned government sectors and nongovernmental organizations should work to improve households’ income through implementing different development and income generating strategies. In addition, working with local cooperatives and diversifying the means of awareness creation about the scheme were also recommended as critical issues in improving household head’s participation in community based health insurance.