Willingness to pay for social health insurance among public civil servants: A cross-sectional study in Dessie City Administration, North-East Ethiopia
- PMID: 35928482
- PMCID: PMC9343680
- DOI: 10.3389/fpubh.2022.920502
Willingness to pay for social health insurance among public civil servants: A cross-sectional study in Dessie City Administration, North-East Ethiopia
Abstract
Background: The readiness to pay for health insurance has an impact on universal health care. This study investigated the willingness of public civil servants in Dessie City Administration, North-East Ethiopia, to pay for social health insurance and associated factors.
Methods: From April to May 2021, a cross-sectional study was undertaken. The sectors from which the samples were proportionately allocated were chosen using a multistage sampling procedure. Using their payroll list as a sampling frame, simple random sampling was done to recruit them. A semi-structured self-administered questionnaire was used to collect data. Epi Data version 3.1 was used to enter, code, and clean the data, which was then exported to SPSS version 23 for analysis. To determine relationships, bi-variable and multivariable analyses were utilized. Candidates for multivariable analysis were variables with a p-value ≤ 0.3 in bi-variable analysis. AOR with a 95% CI was used to determine the strength and direction of association. Statistical significance was defined at p-value < 0.05.
Results: A total of 796 employees took part in the study, with a 94.42% response rate. Overall, 29.60% of them were willing to pay for the scheme (95% CI: 26.4, 33%). The decision to pay was influenced by favorable perception (AOR = 2.43, 95% CI: 1.72, 3.44), household income < Birr 5,000 (AOR = 0.26, 95% CI: 0.14, 0.48), acute illness (AOR = 0.48, 95% CI: 0.32, 0.72), bachelor level education (AOR = 0.44, 95% CI: 0.28, 0.70), master and above level education (AOR = 0.26, 95% CI: 0.14, 0.49), and age 25-29 years (AOR = 1.97, 95 % CI: 1.08, 3.57).
Conclusion: The willingness of the civil servants to pay for social health insurance was low, and it was influenced by their attitudes toward the scheme, the occurrence of severe illness, income level, educational status, and age.
Keywords: Ethiopia; factors; public civil servants; social health insurance; willingness to pay.
Copyright © 2022 Amilaku, Fentaye, Mekonen and Bayked.
Figures



Similar articles
-
Willingness to pay for social health insurance in Ethiopia: A systematic review and meta-analysis.Front Public Health. 2023 Mar 22;11:1089019. doi: 10.3389/fpubh.2023.1089019. eCollection 2023. Front Public Health. 2023. PMID: 37033025 Free PMC article.
-
Willingness to pay for social health insurance and its associated factors among public servants in Addis Ababa, Ethiopia: a cross-sectional study.BMC Health Serv Res. 2022 Jul 13;22(1):909. doi: 10.1186/s12913-022-08304-8. BMC Health Serv Res. 2022. PMID: 35831860 Free PMC article.
-
Determinants of willingness to pay for community-based health insurance scheme among households in rural community of southern Ethiopia.BMC Health Serv Res. 2023 Dec 6;23(1):1365. doi: 10.1186/s12913-023-10406-w. BMC Health Serv Res. 2023. PMID: 38057806 Free PMC article.
-
Willingness to pay for Social Health Insurance and associated factors among Public Civil Servants in Ethiopia: A systematic review and meta-analysis.PLoS One. 2024 Feb 9;19(2):e0293513. doi: 10.1371/journal.pone.0293513. eCollection 2024. PLoS One. 2024. PMID: 38335220 Free PMC article.
-
Is Ethiopian community-based health insurance affordable? Willingness to pay analysis among households in South Central, Ethiopia.PLoS One. 2022 Oct 27;17(10):e0276856. doi: 10.1371/journal.pone.0276856. eCollection 2022. PLoS One. 2022. PMID: 36301951 Free PMC article.
Cited by
-
Willingness to pay for National Health Insurance Services and Associated Factors in Africa and Asia: a systematic review and meta-analysis.Front Public Health. 2024 Apr 19;12:1390937. doi: 10.3389/fpubh.2024.1390937. eCollection 2024. Front Public Health. 2024. PMID: 38706546 Free PMC article.
-
Willingness to pay for social health insurance in Ethiopia: A systematic review and meta-analysis.Front Public Health. 2023 Mar 22;11:1089019. doi: 10.3389/fpubh.2023.1089019. eCollection 2023. Front Public Health. 2023. PMID: 37033025 Free PMC article.
-
Psychosocial determinants of the willingness to pay for social health insurance among workers at a commercial bank in Dessie, Ethiopia: a multi-setting study.Front Public Health. 2025 Jan 23;12:1403568. doi: 10.3389/fpubh.2024.1403568. eCollection 2024. Front Public Health. 2025. PMID: 39917523 Free PMC article.
-
Social Health Insurance and Healthcare Seeking Behavior in Urban Ethiopia.Ann Glob Health. 2023 Nov 28;89(1):84. doi: 10.5334/aogh.4240. eCollection 2023. Ann Glob Health. 2023. PMID: 38046537 Free PMC article.
References
-
- World Health Organization. Universal Health Coverage (UHC). Geneva: World Health Organization (2021). Available online at: https://www.who.int/news-room/fact-sheets/detail/universal-health-covera...
-
- Federal Federal Democratic Republic of Ethiopia Council of Ministers Social Health Insurance Proclamation 690/2010 . Addis Ababa: Federal Negarit Gazeta; (2010). p. 5494–9.
-
- McGhan WF. Pharmacoeconomics. in: Troy D, editor. Remington: The Science and Practice of Pharmacy. Lippincott Williams & Wilkins; (2005). p. 2070–81.
MeSH terms
LinkOut - more resources
Full Text Sources
Medical
Miscellaneous