Abstract:

Enrollment into any form of insurance is very low in Katsina State, with most people paying out of pocket for health care. The utilization of community-based health insurance will provide financial risk protection and improve health outcomes. The objective of the study is to compare differences in Utilization between community-based health insurance member households and non-member households and to identify factors associated with the utilization. A comparative cross-sectional descriptive study was conducted among household heads in Katsina State, Nigeria. Targeted participants were selected using multistage sampling techniques. Primary data was generated using Open Data Kit (ODK), which was later downloaded and exported to SPSS version 20® for statistical analysis. Mean, and standard deviation from the mean (Mean ± SD) were used to study population characteristics towards utilization of CHI. The statistical significance level of analyzed variables were accepted at P≤0.05. The mean age of respondents was 46.82±13 and 44±12.5 years for CBHI enrolled and non-ensured groups, respectively. Heads of the households were predominantly males and currently married, with 97.3% and 93.3% for CBHI members compared to 82.7% and 99.3% of non-member households, respectively. The enrolled CBHI group utilizes PHC services more than the non-enrolled group(p<0.05) with age, marital status, education, number of children, and distance to health facilities all associated with Utilization. Utilization of CBHI was higher among enrolled groups than non-enrolled groups. Many factors, such as age, marital status, education level, and Payment of transportation to the facility, affect utilization of these services. We recommend CBHI be expanded, poor and vulnerable groups are given special consideration, and people not enrolled should be encouraged to join.

References:

[1] Carrin, G. (2003). Community-based Health Insurance Schemes in Developing Countries; facts, problems, and perspectives. World Health Organization, Geneva.

[2] The World Health Report; Health System Financing; The Path to Universal Coverage, 2010, http://www.who.int/whr/2010/whr10_en.pdf Accessed 2 nd August 2020.

[3] WHO 2020 Community-Based Health insurance Scheme. https://www.who.int/news-room/factsheets/detail/community-based-health-insurance2020.

[4] Onwujekwe.O, Valenyi. E. Feasibility of voluntary health insurance in Nigeria. 2006. The World Bank.

[5] National Bureau of Statistics (NBS) and United Nations Children’s Fund (UNICEF). 2017 Multiple Indicator Cluster Survey 2016-17, Survey Findings Report. Abuja, Nigeria; National Bureau of Statistics and United Nations Children’s Fund.

[6] Nasiru, L., Mohammed, T.S., Hassan, A., Shamsuddeen, Y (2021). Health Care Access and Utilization among Households in Katsina State North-western, Nigeria. International Journal of Tourism and Hotel Management; 2641-6948.

[7] Yahaya S.S, Mustapha M, , Lawal N , Runka JY. Knowledge of Community Based Health Insurance among Residence of Katsina State, Nigeria; A Comparative Cross-Sectional Study. Texila International Journal of Academic Research Special Edition Apr 2022.

[8] Araoye MO. Research Methodology with Statistics for Health and Social Sciences, first edition. Nathadex publishers Ilorin, 2004;25- 120.

[9] Gnawali DP, Pokhrel S, Sié A, Sanon M, De Allegri M, Souares A, Dong H, Sauerborn R. The effect of community-based health insurance on the utilization of modern health care services; evidence from Burkina Faso. Health Policy. 2009 May;90(2-3);214-22. doi; 10.1016/j.healthpol.2008.09.015. Epub 2008 Nov 25. PMID; 19036467.

[10] Asmamaw Atnafu Tsegaye Gebremedhin. Community-Based Health Insurance Enrollment and Child Health Service Utilization in Northwest Ethiopia; A Cross-Sectional Case Comparison Study. Clinico Economics and Outcomes Research 2020;12.

[11] Atnafu A, Gebremedhin T. Community-Based Health Insurance Enrolment and Child Health Service Utilization in Northwest Ethiopia; A Cross-Sectional Case Comparison Study. Clinicoecon Outcomes Res. 2020 Aug 10;12;435-444. doi; 10.2147/CEOR.S262225. PMID; 32848434; PMCID; PMC7428314.

[12] Sarah Alkenbrack, Magnus Lindelow. The impact of community-based health insurance on utilization and out-of-pocket expenditures in Lao People’s Democratic Republic. Health Econ. 2015 Apr;24(4);379-99.

[13] Bayked EM, Kahissay MH,Workneh BD. Factors affecting the uptake of community-based health insurance in Ethiopia; a systematic review. Int J Sci Rep 2021;7(9);459-67. (5) (PDF) Factors affecting community based health insurance utilization in Ethiopia; A systematic review. Available from: https;//www.researchgate.net/publication/340193552_Factors_affecting_community_based_health_insurance_utilization_in_Ethiopia_A_systematic_review [accessed May 20 2022].