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Review
. 2022 Nov 6:10:20503121221135876.
doi: 10.1177/20503121221135876. eCollection 2022.

Willingness to pay for community-based health insurance and associated factors in Ethiopia: A systematic review and meta-analysis

Etsay Woldu Anbesu  1 , Oumer Abdulkadir Ebrahim  2 , Nigus Desalegn Takele  1
Affiliations
Review

Willingness to pay for community-based health insurance and associated factors in Ethiopia: A systematic review and meta-analysis

Etsay Woldu Anbesu et al. SAGE Open Med. .

Abstract

In Ethiopia, there is low enrollment and a wide discrepancy in willingness to pay for community-based health insurance schemes, and there is a lack of nationally representative data on willingness to pay for community-based health insurance. Thus, this systematic review and meta-analysis aimed to estimate the pooled prevalence of willingness to pay for community-based health insurance and associated factors in Ethiopia. This was developed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Databases such as PubMed/Medline, CINAHL, African Journals Online, and Google Scholar searches were performed to retrieve available published and unpublished studies from December 15 to May 17, 2022. Two independent reviewers screened the retrieved articles. Critical quality appraisal was performed using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument. To investigate the sources of heterogeneity, subgroup analysis and meta-regression were performed based on region, study setting (rural/urban), and sample size. RevMan software and STATA 14 software were used for the statistical analysis. A random-effect model was used to estimate the effect size at a 95% confidence interval. A total of 190 studies were retrieved, and six studies were included in the final meta-analysis. The pooled prevalence of willingness to pay for community-based health insurance was 78 (95% confidence interval: 74, 81). A subgroup analysis by region indicated the lowest proportion of willingness to pay community-based health insurance in the Oromia region, 76% (95% confidence interval: 68, 84), and the highest in the Amhara region, 79% (95% confidence interval: 77, 81). Nearly three in four households were willing to pay for community-based health insurance in Ethiopia. Thus, awareness of willingness to pay community-based health insurance is mandatory to improve the implementation of community-based health insurance.

Keywords: Ethiopia; community-based health insurance; systematic review and meta-analysis; willingness to pay.

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Conflict of interest statement

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Flow chart of study selection for meta-analysis of willingness to pay community-based health insurance in Ethiopia, 2022.
Figure 2.
Figure 2.
Forest plot showing the pooled prevalence of willingness to pay community-based health insurance in Ethiopia.
Figure 3.
Figure 3.
Forest plot showing the association between educational status and willingness to pay community-based health insurance in Ethiopia.
Figure 4.
Figure 4.
Forest plot showing the association between wealth index and willingness to pay community-based health insurance in Ethiopia.
See this image and copyright information in PMC

References

    1. Dror DM, Chakraborty A, Majumdar A, et al.. Impact of community-based health insurance in rural India on self-medication & financial protection of the insured. Indian J Med Res 2016; 143(6): 809–820. - PMC - PubMed
    1. Woldemichael A, Shimeles A. Measuring the impact of micro-health insurance on healthcare utilization: a Bayesian potential outcomes approach. Abidjan, Côte d’Ivoire: African Development Bank Group, 2015.
    1. Chatterjee C, Joshi R, Sood N, et al.. Government health insurance and spatial peer effects: new evidence from India. Soc Sci Med 2018; 196: 131–141. - PubMed
    1. FMOH and Ethiopian Health Insurance Agency. Evaluation of community-based health insurance pilot schemes in Ethiopia: final report, 2015, https://www.hfgproject.org/evaluation-cbhi-pilots-ethiopia-final-report/
    1. World Health Organization. The world health report: health systems financing: the path to universal coverage: executive summary. Geneva: World Health Organization, 2010. - PMC - PubMed

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