COMPARING HEALTHCARE SERVICE UTILIZATION IN INSURED VS NON-INSURED HOUSEHOLDS IN RURAL ATSBI-WOMBERTA
Keywords:
community, health insurance, health care service utilization, rural, Atsbi-WombertaAbstract
Community-based health insurance schemes (CBHI) in Africa are gaining attention due to high healthcare costs in developing nations, affecting 6% of individuals in extreme poverty. The World Health Organization emphasizes the need for sustainable health funding schemes to ensure access to health services. Ethiopia faces poor healthcare funding, making it one of the world's poorest nations. Tigray implemented community-based insurance as a pilot study in 69 rural communities since 2010. This study aimed to compare differences in healthcare service utilization between community-based health insurance among insured and non-insured households in the rural Atsbi-Wemberta district. A community-based comparative cross-sectional study with a qualitative approach was conducted on 172 households. Data was analyzed using SPSS, and inferential statistics were used to measure factors' association with outcome variables. A Kebelle study revealed that most respondents were female-headed, engaged in both insurance schemes, and had higher education levels. Marital status was also significant, with 89% living with their families. The majority were married, with 91.8% insured and 86.0% uninsured. Family size and income were significant factors, with high-salary households less likely to be members of the Community-Based Health Insurance (CBHI) scheme. The study found that most participants considered themselves intermediate healthcare providers, with limited service due to affordability and segregation. The study suggests increasing healthcare service utilization by introducing Community Benefits Health Insurance (CBHI) to improve access to healthcare and promote good governance. However, the study faces criticism for unfairness and insufficient benefits for non-insured participants. Households who were enrolled in CBHI (56.2%) were more likely to use health care services than households who were not enrolled (43.8%) (χ2=21.359, p<0.001). Community Benefits Insurance (CBHI) has increased healthcare utilization among insured households.
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