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KMID : 1138720200460020001
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Korean Public Health Research
2020 Volume.46 No. 2 p.1 ~ p.12
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Determinants of enrollment in community based health insurance among men in Rwanda: A case study of Musanze District
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Felix NDAYISABA
Jin Ki-Nam
Koo Jun-Hyuk
Cha Sun-Mi
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Abstract
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Purpose: Community based health insurance(CBHI) is a major concern especially in developing countries. CBHI was designed to help people access to healthcare services at reasonable cost. Considering that men are the key decision makers in family, we need to understand what factors influence the decision to enroll in CBHI. This study aims to assess the determinants that influence the enrollment in the scheme by Rwandan men.
Methods: For this study, we selected cases from Musanze District, one of the thirty districts in Rwanda. The questionnaires were distributed to Rwandan men who have not enrolled in the CBHI yet. By using quota sampling method, we surveyed 100 respondents. A chi-square test was conducted to understand the overall relationship between the measured variables. After that, logistic regression analysis was performed based on the Anderson model to identify how predisposing factors, enabling factors, and need factors influence the intention to enroll in CBHI.
Main Results: The chi-square test reported that age, decision maker type, income, social network, size of household, distance to healthcare facility, perceived health status and perceived service quality were related to intention to enroll in CBHI. These relationships were found to be statistically significant. By using logistic regression analysis, we found statistically significant factors: the size of household, attitude toward CBHI, and income.
Conclusion: This results imply that CBHI scheme would encounter with sustainability problems. The larger families could be hesitant to enroll in CBHI because they need to mobilize large amounts of cash all at once. Adopting monthly payment instead of requesting annual payment or flat rate payment regardless of family size can be considered. In addition, the benefits package needs to be redesigned to attract higher-income groups to enroll in CBHI
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KEYWORD
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CBHI, Rwanda, intention to enroll in health insurance
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