The Contribution of Community Based Health Insurance (CBHI) in Improving Access and Utilization of Healthcare Services: The Case of Adea District, East Shoa Zone, Oromia Region, Ethiopia

Abstract

The purpose of this study is to examine the contribution of Community Based Health Insurance (CBHI) in Adea District in improving access to modern healthcare and providing financial protection to CBHI member households. The district has 29,062 households out of which 26,156 are eligible for CBHI membership. Currently 12,341 households are enrolled in the CBHI scheme. Health insurance coverage rate in the district is 45%. The government provides support to the scheme in the form of providing targeted and general subsidies, covering operational expenditures, and providing leadership and technical support. The community is also involved in the governance system of the schemes by participating in the general assembly and board. The study used binary logistic regression model to see if there is a difference in access to modern healthcare and exposure to catastrophic health expenditure. The sample size for the study was 280. The overall response rate was 96.43 percent. The study covered 126 CBHI member households and 144 non CBHI member households. The analysis found significant positive effects of health insurance coverage in improving access of households to modern healthcare services (OR= 2.533). It is established in this study that CBHI member households in Adea Woreda are more likely to use health care services than non CBHI member households in the same Woreda. It also established that households with health insurance coverage have reduced chance of being exposed to catastrophic health expenditures (OR = 0.271). Members of Adea CBHI scheme were provided effective protection against catastrophic health expenditure.