WILLINGNESS TO PAY FOR SOCIAL HEALTH INSURANCE AND ITS DETERMINANTS AMONG HEALTH PROFESSIONALS IN PUBLIC HEALTH FACILITIES OF ADDIS ABABA CITY

Abstract

Background: Ethiopia is one of the countries with high out-of-pocket payments leading to catastrophic health expenditure. The government of Ethiopia introduced social health insurance scheme to reduce the out-of-pocket payments. However, there is limited evidence on willingness to pay for social health insurance among health sector employees in the country. This study aims to assess the willingness to pay for social health insurance scheme and associated factors among health professionals in public health facilities of Addis Ababa, Ethiopia. Methods: An institutional-based cross-sectional study was conducted from May to June, 2024 in selected health centers. The public health centers were selected by using a simple random sampling technique, and the health professionals were recruited by using systematic sampling technique. The data were collected using a pretested self-administered questionnaire. The collected data was entered into Epidata and then exported to SPSS version 26 for further analysis. Descriptive statistics like frequency, percentages, mean and median with the respective measures of dispersions were used to describe the data. Associations with the willingness to pay (WTP) was tested for statistical significance with alpha set at the 0.05 level. The strength of associations with the dependent variables described in Odds Ratio (OR) with their 95% confidence intervals. Result: the responses of 362 participants was included in the final analysis with response rate of 96%. The proportion of willingness to pay for SHI among the health professionals was found to be 27%. The study also revealed factors that show statistically significant association with the willingness of health professionals to pay for SHI were age 25-34 years [AOR:2.59, 95% CI: (1.51-9.17)], educational level above degree [AOR: 4.85, 95% CI:( 2.47–21.22)], income level 5000-1000ETB [AOR: 2.92, 95% CI: (1.32–9.43)], having good perception about benefits of SHI [AOR: 3.67, (95% CI: (1.36–14.87)] and experience recent illness in the last 12 months [AOR: 3.94, 95% CI: (1.22–7.89)]. Conclusion and recommendations: The willingness to pay for social health insurance among the health professionals was unacceptably low in this study. WTP for SHI was found to be influenced by age, perception, net household income, the presence of recent illness, and level of education among the health professionals in the health center of Addis Ababa, Ethiopia. So, stakeholders are recommended to take interventional measures on the identified factors to improve the willingness of health professionals to pay for SHI.