Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study
BackgroundA lack of health insurance is a major barrier to the “health for all” agenda, where out-of-pocket (OOP) spending is the primary healthcare funding mechanism, a characteristic of Ethiopia’s healthcare sector, leading it to plan to fully implement social health insurance (SHI) by 2014, but n...
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Frontiers Media S.A.
2025-01-01
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| author | Alemayehu Mebratu Abate Asnakew Molla Mekonen Abebe Kibret Assfaw Husien Nurahmed Toleha Ewunetie Mekashaw Bayked |
| author_facet | Alemayehu Mebratu Abate Asnakew Molla Mekonen Abebe Kibret Assfaw Husien Nurahmed Toleha Ewunetie Mekashaw Bayked |
| author_sort | Alemayehu Mebratu Abate |
| collection | DOAJ |
| description | BackgroundA lack of health insurance is a major barrier to the “health for all” agenda, where out-of-pocket (OOP) spending is the primary healthcare funding mechanism, a characteristic of Ethiopia’s healthcare sector, leading it to plan to fully implement social health insurance (SHI) by 2014, but not yet, owing to significant opposition from public employees. The objective of this study was to look into the psychosocial determinants of the willingness to pay (WTP) for SHI among employees at a commercial bank in Dessie, Ethiopia.MethodsWe employed a cross-sectional study (October to December 2023) design. A self-administered questionnaire was used to collect the data. We used SPSS 27 to analyze the data. The relationship between dependent and independent variables was determined using the odds ratios at a p value less than 0.05 with a 95% CI.ResultsOf 396 samples, 264 (66.7%) responded, of which 93.9% had information about SHI, mainly from broadcast media (71.0%). More than three-fourths (75.8%) and two-thirds (64.4%), respectively, had poor knowledge and a negative perception regarding SHI. More than half (50.4%) of the participants were willing to pay, of which 88.5% (40.5% of the total participants) were interested in paying the 3.0% premium set by the government. The main reason for the WTP was to help those who could not afford medical costs, while the primary reason for not paying was the scheme’s limited benefit packages. The WTP was found to be significantly affected by being female (AOR = 0.50, 95% CI: 0.26–0.98), being affiliated with orthodox Christianity (AOR = 0.48, 95% CI: 0.23–0.99), the presence of ≥5 family members in the household (AOR = 0.17, 95% CI: 0.06–0.52), experience of illness in the last 6 months (AOR = 4.95, 95% CI: 2.23–11.00), and perception toward it (AOR = 4.07, 95% CI: 2.03–8.17).ConclusionThe WTP for the scheme was suboptimal, attributed to limited benefit packages, lack of medicines and equipment, and poor healthcare quality, and significantly influenced by being female, being affiliated with orthodox Christianity, family size, experience of illness in the last 6 months, as well as perceptions toward it. |
| format | Article |
| id | doaj-art-c36f7971bb6744eab31f827d1bf75b55 |
| institution | Kabale University |
| issn | 2296-2565 |
| language | English |
| publishDate | 2025-01-01 |
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| spelling | doaj-art-c36f7971bb6744eab31f827d1bf75b552025-01-23T06:56:22ZengFrontiers Media S.A.Frontiers in Public Health2296-25652025-01-011210.3389/fpubh.2024.14035681403568Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting studyAlemayehu Mebratu Abate0Asnakew Molla Mekonen1Abebe Kibret Assfaw2Husien Nurahmed Toleha3Ewunetie Mekashaw Bayked4Department of Pharmacy, Tita Health Center, Dessie, EthiopiaDepartment of Health Systems and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, EthiopiaDepartment of Psychology, Institute of Teachers’ Education and Behavioral Science, Wollo University, Dessie, EthiopiaDepartment of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, EthiopiaDepartment of Pharmacy, College of Medicine and Health Sciences (CMHS), Wollo University, Dessie, EthiopiaBackgroundA lack of health insurance is a major barrier to the “health for all” agenda, where out-of-pocket (OOP) spending is the primary healthcare funding mechanism, a characteristic of Ethiopia’s healthcare sector, leading it to plan to fully implement social health insurance (SHI) by 2014, but not yet, owing to significant opposition from public employees. The objective of this study was to look into the psychosocial determinants of the willingness to pay (WTP) for SHI among employees at a commercial bank in Dessie, Ethiopia.MethodsWe employed a cross-sectional study (October to December 2023) design. A self-administered questionnaire was used to collect the data. We used SPSS 27 to analyze the data. The relationship between dependent and independent variables was determined using the odds ratios at a p value less than 0.05 with a 95% CI.ResultsOf 396 samples, 264 (66.7%) responded, of which 93.9% had information about SHI, mainly from broadcast media (71.0%). More than three-fourths (75.8%) and two-thirds (64.4%), respectively, had poor knowledge and a negative perception regarding SHI. More than half (50.4%) of the participants were willing to pay, of which 88.5% (40.5% of the total participants) were interested in paying the 3.0% premium set by the government. The main reason for the WTP was to help those who could not afford medical costs, while the primary reason for not paying was the scheme’s limited benefit packages. The WTP was found to be significantly affected by being female (AOR = 0.50, 95% CI: 0.26–0.98), being affiliated with orthodox Christianity (AOR = 0.48, 95% CI: 0.23–0.99), the presence of ≥5 family members in the household (AOR = 0.17, 95% CI: 0.06–0.52), experience of illness in the last 6 months (AOR = 4.95, 95% CI: 2.23–11.00), and perception toward it (AOR = 4.07, 95% CI: 2.03–8.17).ConclusionThe WTP for the scheme was suboptimal, attributed to limited benefit packages, lack of medicines and equipment, and poor healthcare quality, and significantly influenced by being female, being affiliated with orthodox Christianity, family size, experience of illness in the last 6 months, as well as perceptions toward it.https://www.frontiersin.org/articles/10.3389/fpubh.2024.1403568/fullsocial health insurancewillingness to paypsychosocial factorsbankersEthiopia |
| spellingShingle | Alemayehu Mebratu Abate Asnakew Molla Mekonen Abebe Kibret Assfaw Husien Nurahmed Toleha Ewunetie Mekashaw Bayked Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study Frontiers in Public Health social health insurance willingness to pay psychosocial factors bankers Ethiopia |
| title | Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study |
| title_full | Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study |
| title_fullStr | Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study |
| title_full_unstemmed | Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study |
| title_short | Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study |
| title_sort | psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in dessie ethiopia a multi setting study |
| topic | social health insurance willingness to pay psychosocial factors bankers Ethiopia |
| url | https://www.frontiersin.org/articles/10.3389/fpubh.2024.1403568/full |
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