BMC Public Health (Aug 2022)

Spatial distribution and associated factors of community based health insurance coverage in Ethiopia: further analysis of Ethiopian demography and health survey, 2019

  • Bewuketu Terefe,
  • Tewodros Getaneh Alemu,
  • Masresha Asmare Techane,
  • Chalachew Adugna Wubneh,
  • Nega Tezera Assimamaw,
  • Getaneh Mulualem Belay,
  • Tadesse Tarik Tamir,
  • Addis Bilal Muhye,
  • Destaye Guadie Kassie,
  • Amare Wondim,
  • Bethelihem Tigabu Tarekegn,
  • Mohammed Seid Ali,
  • Beletech Fentie,
  • Almaz Tefera Gonete,
  • Berhan Tekeba,
  • Selam Fisiha Kassa,
  • Bogale Kassahun Desta,
  • Amare Demsie Ayele,
  • Melkamu Tilahun Dessie,
  • Kendalem Asmare Atalell

DOI
https://doi.org/10.1186/s12889-022-13950-y
Journal volume & issue
Vol. 22, no. 1
pp. 1 – 13

Abstract

Read online

Abstract Background Community-Based Health Insurance is an emerging concept for providing financial protection against the cost of illness and improving access to quality health services for low-income households excluded from formal insurance and taken as a soft option by many countries. Therefore, exploring the spatial distribution of health insurance is crucial to prioritizing and designing targeted intervention policies in the country. Methods A total of 8,663 households aged 15–95 years old were included in this study. The Bernoulli model was used by applying Kulldorff methods using the SaTScan software to analyze the purely spatial clusters of community based health insurance. ArcGIS version 10.3 was used to visualize the distribution of community-based health insurance coverage across the country. Mixed-effect logistic regression analysis was also used to identify predictors of community-based health insurance coverage. Results Community based health insurance coverage among households had spatial variations across the country by regions (Moran’s I: 0.252, p 5, 0.82(AOR = 0.82, CI: 0.69,0.96),respectively and regions Afar, Oromia, Somali, Benishangul Gumuz, SNNPR, Gambella, Harari, Addis Ababa and Dire Dawa was 0.002(AOR = 0.002, CI: 0.006,0.04), 0.11(AOR = 0.11, CI: 0.06,0.21) 0.02(AOR = 0.02, CI: 0.007,0.04), 0.04(AOR = 0.04, CI: 0.02,0.08), 0.09(AOR = 0.09, CI: 0.05,0.18),0.004(AOR = 0.004,CI:0.02,0.08),0.06(AOR = 0.06,CI:0.03,0.14), 0.07(AOR = 0.07, CI: 0.03,0.16) and 0.03(AOR = 0.03, CI: 0.02,0.07) times less likely utilize community based health insurance than the Amhara region respectively in Ethiopia. Conclusion Community based health insurance coverage among households in Ethiopia was found very low still. The government needs to develop consistent financial and technical support and create awareness for regions with lower health insurance coverage.

Keywords