Effects of community-based health insurance on modern family planning utilization in Ethiopia
Gates Open Research , Volume 3; doi:10.12688/gatesopenres.12960.2
Abstract: Background: Community-based health insurance (CBHI) has been established in a number of developing countries to expand access to modern health care service. However, few studies have focused on health care utilization of CBHI members in Ethiopia. Accordingly, the aim of this study was to assess the effect of CBHI on modern family planning (FP) utilization as part of its routine outcome monitoring activities. Methods: The USAID Transform: Primary Health Care project, conducted a continuous monitoring follow up visit using a multistage sampling technique in its four major targeted regions. A total of 3433 households were selected and 3313 women of reproductive age (15-49 years) were interviewed. The questionnaire captured the CBHI status of each household and FP use data from randomly selected women. Microsoft Access database was used to enter the data, which was then transferred to SPSS Version 20 for further analysis. Results: 49% of women (aged 15-49 years) were found to be enrolled in CBHI scheme. Half of the women (50.2%) use any family planning method, of which 49% of them used modern family planning method in project-supported areas. Over half of women (57%) who are exposed to CBHI schemes utilized family planning method which is statistically significant Conclusions: Modern FP utilization among insured women was higher compared with uninsured women. While FP methods are provided for free, CBHI enrollment improves FP use among women of child-bearing age. Women who have access to CBHI may frequently visit health facilities seeking services for themselves and their families, during which they may be introduced to FP services. This in turn may improve their awareness and attitude towards FP. The results will increase awareness for program implementer's of the benefits of CBHI schemes in FP programming, particularly in rural settings, and provide an opportunity to increase lifelong returns in Ethiopia.
Keywords: women / child / insurance / VisIt / Cbhi / Family Planning Utilization / FP use
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