Health Seeking Behavior among Community-Based Health Insurance Insured and Non-Insured Households: Evidence from Abraha WeAtsbeha Village in Rural Tigray

Abstract

Background: The government of Ethiopia has undertaking various initiatives of public health reforms towards universal health care. Community Based Health Insurance (CBHI) is a new practice introduced to the rural population with the intention of accessing quality health care service.
Objective- the main objective of this study is to examine whether the scheme enhance health seeking behavior of the rural people.
Methods- it employed mixed research design. Participants were selected using both probability and non-probability sampling techniques. Survey questionnaires, FGD and key informant interviews were used as data collection methods. The reliability of the survey questions was checked with Cronbach’s alpha and measures of equivalence item analysis methods in pilot testing and found to be strong consistent (r=0.78 & α=0.769) respectively. Data obtained from survey questionnaires was analyzed quantitatively using Pearson product coefficient, mean, standard deviation, two sample t-tests and multiple regressions. Qualitative data was analyzed thematically based on similar experiences and challenges observed in the scheme.
Results- the major finding indicates, the introduction of CBHI as health care package brings significant change in health seeking behavior of the rural people for t(88)= 0.0324, P<0.05 and t(88)= 0.0218, P<0.05 with 95% CI for both “when” and “where” to seek care core values. Poor service quality, moral hazards among scheme members, lack of community participation were identified as bottlenecks in the scheme for F (5, 40) = 4.01, F =0.035, P<0. 05.
Conclusions-The study tried to show how the introduction of CBHI scheme increased the health seeking behavior of the insured households as compared to the non-insured households. This is evident with the significant variation rated responses towards the leading assumptions of where and when to seek care for both the insured and non-insured households.