Abstract:
Abstract
Background: Social health insurance (SHI) is sustainable health care financing mechanisms
which enhances equitable access to improve health services through cross-subsidization. The
amount of out-of-pocket health expenses in Ethiopia reaches about 40% of the total health
expenditure. To solve this, Ethiopia approved CBHI and SHI schemes by, 2010. However, the
implementation of social health insurance was delayed. Institutional based evidence on SHI
acceptance among health professionals and associated factors were low in Northwest Ethiopia.
Objectives: This study aimed to assess the acceptance of social health insurance and its
associated factors among health professionals in government health facilities, Gondar town,
Northwest Ethiopia, 2022.
Methods: Institutional based cross-sectional study design was conducted, from June 1 to July
30, 2022 among five hundred ninety-four health professionals. Participants were selected
using simple random sampling. Data were collected using structured self -administered
questionnaire entered using EPI info software version 7.2 and exported to SPSS version 23
for analysis done. Both bi-variable and multivariable binary logistic regression models were
fitted to identify factors associated acceptance among health professional’s variables having
p-value< 0.25, and 0.05 were used as cut off value for statistical significance for the bi and
multivariable models respectively. The adjusted odds ratio with its 95% confidence interval
(CI) was used as a measure of association.
Results: From the total 583 health professionals who participated in this study 24.7%
(24%,95% CI 20.4,27.6) of the respondents were willing to pay 3% or more of their monthly
salary. Health professionals’ acceptance for SHI significantly associated with educational
status, degree (AOR 4.29; 95%CI: 1.61, 11.39), having good knowledge on SHI (AOR 5.08;
95%CI: 2.48, 10.4), favorable attitudes towards social health insurance (AOR 3.12; 95%CI:
1.62, 5.98), trust on HIA (AOR 10.2; 95%CI: 4.77, 22.1) and perceive quality health care
services (AOR 2.09; 95%CI: 1.03, 4.23).
Conclusion: The study indicated that there was a low proportion of health professionals accepted
for SHI. Factors such as educational status, knowledge, attitude towards SHI, trust HIA and
perceive quality health care services were significantly associated with acceptance for SHI. It
needs adequate awareness creations and Discussion about the relevance of SHI benefit package.
Key Words: Social health insurance, Gondar Town, Ethiop
