Households’ Willingness To Pay For Community Based Health Insurance And Its Determinants. The Case Of Ambo Town, West Shewa Zone, Ethiopia

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