Abstract:
Ethiopia launched Community based health insurance in 2010 seeking to put an end to
potentially destructive out-of-pocket health expenses for 85 percent of Ethiopians
population who works in the informal sector. Yet only 29.27% were registered for the
scheme in Ambo town in 2023. Most of previous studies focused on rural areas with
different results across place and time of study. This study aimed to investigate
households’ willingness to pay for community based health insurance and the
determinant factors in Ambo town. Household based cross-sectional research design was
utilized among 388 sampled households and ten key informants in Ambo town. Multi
stage sampling technique was used to select study participants and purposive sampling
technique was applied to select key informants. Quantitative data was collected using
semi-structured questionnaire through survey schedule and analyzed using stata/MP 14.0
software. Descriptive statistics, Inferential statistics and Heckman two step selection
model were employed for quantitative data analysis. From the total respondents 77.58%
were show their willingness to pay for the community based health insurance. The mean
amount of maximum willingness to pay was 544.46 birr/year (S.D+ 292.17). The result of
the first stage Heckman selection (Probit regression model) prevailed that a unit increase
in the overall perception, knowledge and income increases the probability of willing to
pay for community based health insurance by 21.97%, 23.20 and .0038% respectively,
other things remain constant. According to the Heckman second stage (OLS) model
result, if income, and perception increases by one unit, the households’ maximum amount
willing to pay increases by 0.035 birr and 150.97 birr respectively, other things remain
constant. Existence of quality service, provision of enough drugs and availability of good
information will increase perception and knowledge of the community which in return
increase the willingness to pay. So, the ministry of health and CBHI agency together with
stakeholders should work on the availability of good information, capacity building of
health care providers and availability of drugs to enhance quality service. The
government also consider income, knowledge and perception factors in current CBHI
implementation and in the future on social health insurance program
