Socio‑demographic characteristics of households
Out of 296 sampled household heads, 285(96.3%) were participated in the study. Among this 252(88.4%) were males and 33(11.6%) were female household heads. The age of household heads from, 18-28 (10.9%), 29-39 (38.2%), 40-49(34.1%) and 50 and above (16.8%).With respect to residence, 231(81.1%) were rural and 54(18.9%) were urban. The majority of respondents were orthodox followers 246(86.3%).With regard to marital and educational statues, 254(89%) were married and 126(44.2%) of them illiterate. Regarding to occupation of household heads, the majority were farmers 173(60.7%) and the rest 112(39.3%) were labour, government employee, housewife and merchants. The mean average of monthly income of family were 1,658 ETB and family size of household heads from 1-3 (47.7%), 4-6(41.4%) and 7 and above (10.9%) (Table, 1).
The Levels of WTP CBHI: The majority of study participants were willing to paid CBHI 256(89.8%) and the remaining not paid. The main reasons for not WTP were thinking that , out pocket payment it is better to get effective treatments 16(5.6%) and the government do not cover all the needs services in CBHI scheme 13(4.6%).From the total respondents, 200(70.2%) were CBHI premium is affordable and 85(29.8%) were not affordable (Table, 2).
Health status and health care utilization characteristics of respondents
Out of the total 285 study participants 44(15.4%) were started enrolling in CBHI before one year ago, 72(25.3%) before two years ago, 102(35.8%) three years ago and 67(23.5%) before four year ago. With regard to join CBHI, 251(88.1%) were voluntary and 34(11.9%) were mandatory or without needs. Among respondents, 266(93.3%) reported that enrolling in CBHI have advantages and the benefits were, 231(86.8%) reduce OOP expenditure, 22(8.3%) improve health status, 6(2.3%) reduce the risk of severity and 7(2.6%) were foster productivity. From 285 study participants, covering medical expense before join CBHI, 264(92.6%) were OOP, 14(4.9%) borrowing and 7(2.6%) were bring from Ikub and idir.
The study indicated that, 256(89.2%) of respondents were renew your and family id number timely and the registration and renewal cost was, 285 (100%) coved by self-sponsored. The majority of study participants, 228(80%) were ill during the past one year. From this, 228(80%) were obtained treatment and 106(46.5%) were got treatment from private health center. Regarding the distance, from home of the household to reach health facility, 197(86.4%) were take > 60 minutes. From the total of 285 respondents, 123(43.2%) were CBHI package fulfil the needs of household treatment as well as 207(72.6%) study participants were reported that CBHI health facility provided good services. The perceived quality of health care service in the district was low. The main challenges use services in government health institution, 65(34.2%) mentioned that absence of available medicine, 62(32.7%) were poor service delivery, 50(26.3%) were lack of enough laboratory equipment, 8(4.2%) were health professionals do not have good behavior and 5(2.6%) were shortage of ambulance services (table, 3).
Perception and satisfaction of households towards join and pay for CBHI
The majority of household heads responded that, 113 (39.6%) were agree with only the poor people join CBHI scheme. With respect to the happiness of the current premium to CBHI services, out of the total 285 respondents 175(61.4%0) were agree. The study indicated that the health professional committed to improve health status of target population, 101(35.4%) respondents were agree and 103(36.1%) were neutral. To determine the overall level of perceptions with the CBHI scheme, internal consistency (Cronbach’s alpha) was first calculated for the scale items measuring perceptions: the items had a Cronbach’s alpha of 0.414.The mean of attitude was 7.95 ±2.297 (range from 3 –15).
The study show that, 101 (35.4%) of respondents were low satisfied and 14(4.9%) were very satisfied on health care utilization in CBHI schemes. From 285 study participants, 177(62.1%) were satisfied on willingness to pay for CBHI services and only 14(4.9%) of respondent were very high satisfied on laboratory services. To identify the overall prevalence of satisfaction in CBHI scheme, internal consistency was first calculated for the scale items measuring satisfaction: the items had a Cronbach’s alpha of 0.697. The mean of attitude was 8.32 ±2.298 (possible range 3 –15) (table, 4).
Independent Predictors of Willingness to Pay CBHI
In bivariate analysis residence, religious, occupational status, premium affordable, enrolling in CBHI have advantage, distance household home to reach HF, join CBHI, time waited to see medical provide, CBHI package fulfil the needs of HH treatment, CBHI health facilities provided a good service and overall CBHI service levels were identified as candidate variables (p-value <0.25) and were considered for or enter to multivariate analysis (table, 5).
Multivariate analysis of factors associated with willingness of HH to pay CBHI
In a multivariate analysis, place of residence, premium affordable, join CBHI voluntary , enrolling in CBHI have advantage and distance of household home to reach HF were significantly associated with willingness household to pay CBHI at (P-value <0.05) (table,6).