Abstract:
Background: Ethiopia is currently planning to introduce Social Health Insurance (SHI) that will lead to universal
health coverage and assist a country to achieve its health system’s objectives and to prevent the catastrophic
health expenditure. But there is no evidence until now about the level of acceptance of the proposed SHI among
government-owned companies’ employees. Therefore, this study was intended to assess the acceptance of SHI and
associated factors among government-owned companies’ employees in northwest Ethiopia.
Methods: An institution-based cross-sectional study was conducted from February 1 to April 30, 2019. A randomly
selected 541 government-owned companies’ employees were participated in the study. A pretested selfadministered structured questionnaire was used that consisted sociodemographic and economic, health statusrelated factors, attitude (measured by 12 items), organizational related factors and knowledge about SHI (measured
by 11 items). Finally, binary logistic regression analysis was performed and in the multivariable logistic regression
analysis, a significant level at a p-value of < 0.05 and Adjusted Odds Ratio (AOR) with 95% confidence interval (CI)
were used to identify factors statistically associated with SHI acceptance.
Results: Overall, 32% (95% CI: 27.7–36.2) of the government-owned companies’ employees accepted the proposed
Ethiopian SHI scheme. Self-perceived health status (AOR: 8.55, 95% CI: 2.69–27.13), heard about SHI (AOR: 1.69, 95%
CI: 1.12–2.54), coverage of medical healthcare cost (AOR: 0.60, 95% CI: 0.39–0.92), work experience (AOR: 0.49, 95%
CI: 0.26–0.89) and quality of healthcare service at the facilities (AOR: 0.17, 95% CI: 0.04–0.71) were significantly
associated with acceptance of SHI among government-owned companies’ employees.
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