Abstract:
Background: The majority of the population in Ethiopia doesn’t have experience of the health insurance. The government of Ethiopia introduced social health insurance for formal sectors as a strategy to improve access and quality health services. While it is not still implemented due to the level of solidarity within a society might be low and low quality health services. There is no study conducted regarding perception of social health insurance in the study setting. Since teachers take a larger share in the civil servants’ place, investigating their perceptions will provide vital information and used as an input for policy makers and organizations working in this area before the implementation of the strategy.
Objectives: The main objective of the study is to assess perception and factors associated to perception towards social health insurance among public school teachers in Gondar city.
Methods: An institution based cross-sectional study design was conducted from March15 to April 15, 2021. Stratified sampling strategy was applied. A total of 422 study participants were included in the study. Data was collected using structured self-administered questionnaire by trained data collectors and supervisors. The data was entered using EPI-INFO version 7 and cleaned and analyzed using SPSS version 25 statistical programs. A five-point Likert scale was applied to determine the perception towards the social health insurance. Multivariable logistic regression analysis was carried out in order to assess association between perception and various explanatory variables.
Results: A total of 412 public school teachers participated in the study with a response rate of 97.6%. From total participants 216(52.4%) were females. The median age was 39 with interquartile range of 13 years. Comprehensive good perception towards social health insurance was 48.3% with 95% confidence interval of 43.2% and 53.2 %. Being male, having bachelor degree, family member faced illness in the past 12 months were predictors for good perception towards social health insurance with [AOR=1.75, 95% CI (1.07, 2.86)], [AOR=1.70, 95% CI (1.01, 2.87)] and [AOR = 2.13, 95% CI (1.12, 4.04)] respectively. In addition, poor self rated health status with [AOR = 3.84, 95% CI (1.26, 11.71)] and who didn’t pay their medical bills from their pocket/own money [AOR = 3.04, 95% CI (1.16, 7.93)] were statistically significant for perception towards social health insurance.
Conclusion and recommendation: Nearly half of public school teachers had good perception for social health insurance. Being male, educational status (BSC), family member faced illness in the past 12 months, poor self rated health status and not paying their medical bills from out of pocket/own money were predictors for good perception towards social health insurance. Thus social health insurance implementers should consider the above factors during the implementation of the insurance schemes.................... Thesis available at ACIPH Library