Abstract

Background - To identify determinants for enrollment decision in the community based health insurance program among informal economic sector engaged societies, North West Ethiopia.

Method:-Unmatched case control study was conducted on 148 cases (member to insurance) and 148 controls (not member to insurance program) from September 1- October 30 2016. Stratified then simple random sampling method was employed. The data were entered in to Epi-info version 7 and exported to SPSS version 20 for analysis. Descriptive statistics, bi-variable, and multi-variable logistic regression analyses were computed to describe the study objectives and identify the determinants of enrolment decision for the insurance program. Odds ratio at 95 % CI was used to describe the association between the independent and the outcome variables.

Result: - A total of 296 respondents (148 cases and 148 controls) were employed. A mean age for cases and controls was 42 ± 11.73 and 40 ± 11.37 years respectively. Majority of respondents were males (87.2 % for cases and 79 % for controls). Family size between 4 and 6 (AOR=2.26; 95% CI: 1.04, 4.89), history of illness by household (AOR=3.24; 95% CI: 1.68, 6.24), perceived amount of membership contribution was medium (AOR=2.3; 95% CI: 1.23, 4.26), being married (AOR=6; 95% CI:1.43, 10.18) and trust on program (AOR=4.79; 95% CI: 2.40, 9.55) were independent determinants for increased enrolment decision in the CBHI. While, being merchant (AOR=0.07; 95% CI: 0.09, 0.6) decreased the enrolment decision.

Conclusion: - Societies enrollment decision to community based health insurance program was determined by demographic, social, economic and political factors. Households with large family size and farmers in the informal sector should be given maximal attention for escalating enrolment decision in the insurance program.

Keywords: - Health, Insurance, Enrolment, Determinant, Ethiopia