| Abstrakt: |
Background: Health insurance schemes have been a preferred strategy to ensure healthy communities towards Universal Health Coverage. However, there are many unanswered questions regarding willingness and ability to pay for health insurance schemes that need to be researched before rolling out UHC in the country. Objective: To explore the community's willingness and ability to pay for health insurance contribution rates (premiums) and to identify enabler and impending factors. Methods: A cross-sectional survey using both qualitative and quantitative data collection techniques was conducted in ten regions, representing each zone of Tanzania Mainland, with rural and urban consideration of selected districts. Interviews were conducted with officials in the protection schemes, both beneficiaries (620) and non-beneficiaries (2946); and health services providers (794) from both public and private facilities at different levels of health facilities. Results: NHIF (8%) and iCHF (5%) are the most common existing health insurance health schemes operating mostly in urban areas (Proportion??) Marketing and enrolment of members to join have been done through community sensitization. Nevertheless, there has been a challenge of clients dropping out which is linked to access to services, medication, low income, and limited understanding of insurance schemes. Only 18.6% of the clients reported having adequate knowledge of the health insurance schemes. Most of the clients responded to having joined the health insurance when they get enough information about the scheme (54.3%), having large extended families (63.7%), knowing the benefits before (63.6%), and having the services guaranteed during emergencies (76.5%). 73.1% of the respondents expressed a willingness to join health insurance, NHIF (41.1%), and iCHF (39.4%). 24.4-68% of the respondents were willing to pay for various UHC packages (30000-216000), however, 41%-81% articulated the ability to pay for these UHC packages. Conclusion: Health insurance scheme coverage is still low. Willingness to pay and Ability to pay for UHC package affects majority of community members who are willing to join HIS. For UHC to succeed clients should be ensured of archiving the targeted expectations such as having clear information, affordability, accessibility, and improved services. [ABSTRACT FROM AUTHOR] |
