Community-based health insurance, healthcare service utilization and associated factors in South Gondar Zone Northwest, Ethiopia, 2021: A comparative cross-sectional study.

INTRODUCTION: Community-based health insurance schemes are becoming increasingly recognized as a potential strategy to achieve universal health coverage in developing countries. Ethiopia has implemented community-based health insurance in piloted regions of the country. The scheme aims to improve the utilization of healthcare services by removing financial barriers. There is a dearth of literature regarding the effect of the insurance scheme on the utilization of healthcare services. METHODS: A community-based comparative cross-sectional study was conducted in the south Gondar Zone. Six hundred fifty-eight participants were selected using a systematic random sampling method. Data were entered into EPI data version 4.4.1 and exported to SPSS version 25 for analysis. Binary logistic regression was used to measure the association of factors with the outcome variable. The result of the final model was expressed in terms of Adjusted Odd Ratios (AOR) and 95% CI. RESULT: Two hundred twenty-three (67.8%) and 111 (33.7%) of the respondents reported that their family members went to health institutions within three months among CBHI users and non-users respectively. The presence of under-five children (AOR = 2, 95% CI = 1.6-2.4), CBHI scheme membership times (AOR = 3, 95% CI = 2.6-3.4), household wealth index rich (AOR = 4, 95% CI = 2.3-6.3), household wealth index medium (AOR = 3, 95% CI = 1.8-5.8) and presence of chronic illness (AOR = 0.5, 95% CI = 0.2-0.8) was associated with health care service utilization. Households who were enrolled in CBHI were more likely to use healthcare services than households who were not enrolled. CONCLUSION AND RECOMMENDATION: Households who were enrolled in CBHI were more likely to use healthcare services than households who were not enrolled. Therefore, health sector leaders and managers in the study area should strengthen their efforts for increasing the enrollment of the community into CBHI.

Preparedness and response to covid-19 in Woreta Town, North West Ethiopia.

Preparedness and early response are proved to be best solutions for a pandemic situation. Well prepared countries have succeeded in containing the transfer of the disease and minimized its adverse impact. Ethiopia has adopted Covid-19 preparedness and response plan. Its implementation has brought good outcomes. The purpose of this study was to explore deeper in to a grass roots situation. It focused particularly on Covid-19 preparedness and response in Woreta town, Northwest Ethiopia. The study employed a qualitative approach. Data were collected from Covid-19 prevention task force members, health care workers and community members using a semi-structured interview. The data collection was conducted from September to October 2020. A framework approach and open code 4.02 software were used in the analysis. The results showed that various structures, including a Covid-19 task force, are created to take preparatory and response measures in the area. As the enforcement of preventive measures is declining, residents continue to be less engaged in their practice of Covid-19 instructions. Generally, the preparedness and response were low in health facilities and in the community. Thus, the local government has to strengthen a persistent and well-informed risk communication by broadening its social base. The existing politicization, rumor, denial and suspicion associated to COVID-19 can only be addresses by implementing a transparent and persuasive communication strategy. The health workers need to renew their effort to transmit health messages. The task force has to consider the pandemic as a strategic problem rather than a short time issue. So, it has to develop a plan to guide its activity. It also need to strengthen its partnership to better enforce preventive guidelines. On the other hand, community members shall not be deceived by the coming of COVID-19 vaccines. Rather they have to focus on prevention mechanisms.