Household satisfaction with community-based health insurance scheme and associated factors in piloted Sheko district; Southwest Ethiopia

BACKGROUND: Community-based health insurance (CBHI) scheme is an emerging strategy for providing financial protection against health-related poverty. It is being piloted in the Sheko district, but community satisfaction with the scheme has not yet studied. Therefore, this study aimed to assess the level of household's satisfaction to CBHI scheme and associated factors in a piloted Sheko district; southwest Ethiopia. METHODS: A community-based cross-sectional study was conducted in Sheko district from March to April 2018. Data was collected on 528 households by using simple random sampling method. Trained data collectors gathered the data using a pre-tested and structured questionnaire. Descriptive statistics, bivariate and multivariable logistic regression analyses were performed. To determine the independent predictors of household's satisfaction to CBHI, a cut point of p values < 0.05 were used. RESULTS: This study showed that more than half (54.7%) of the households were satisfied with the CBHI scheme. Satisfaction to CBHI was positively associated with adequate knowledge of CBHI benefit packages (AOR = 2.29, 95% CI = 1.55-3.38), type of health facility visit (AOR = 1.93, 95% CI = 1.09-3.39), laboratory service provision (AOR = 2.07, 95% CI = 1.15-373) and length of enrollment (AOR = 1.53, 95% CI = 1.01-2.32). CONCLUSIONS: Household's satisfaction to CBHI scheme was moderate. Modifiable factors, including adequate knowledge of CBHI benefit packages, type of health facility visit, laboratory service provision, and length of enrollment were independent determinants of satisfaction. In order to augment enrollee's satisfaction to CBHI, efforts should be given to improving their knowledge of CBHI benefit packages through education and information campaigns. Furthermore, due consideration should also be given to improving the quality of health services.