Background: Community-based health insurance is designed to provide financial protection and reduce out-of-pocket payments for health care. Direct out-of-pocket payments for health care restrict access to health services and compromise household wellbeing. Objective: To assess healthcare service utilization and associated factors among members and non-members of community-based health insurance in Addis Ababa, Ethiopia, in 2025. Method: A community-based comparative cross-sectional study was conducted from March 6 to April 8, 2021. Multistage sampling was used to select 366 households (183 insured, 183 uninsured). Data were collected through face-to-face interviews using a structured questionnaire. Data entry and analysis were performed using EPI INFO v7 and SPSS v25, respectively. Descriptive statistics, two-sample t-tests, and logistic regression were used. Results: A total of 354 households (178 insured, 176 uninsured) participated, yielding a response rate of 97.5%. Healthcare service utilization was significantly higher among CBHI members (73.6%) compared to non-members (55.7%) (t = –3.579, p 0.05). For CBHI members, significant predictors included sex of household head and presence of illness episode. For non-members, sex, marital status, and chronic illness were significant predictors. Conclusion: CBHI membership is significantly associated with higher healthcare service utilization. Expanding CBHI coverage and addressing financial and perceptual barriers are recommended to improve healthcare access.
Abdo et al. (2026) studied this question.