Women’s enrollment in community-based health insurance and its determinants in Sidama national regional state, Ethiopia, 2024: A multilevel analysis

Kare Chawicha Debessa, Keneni Gutema Negeri and Mesay Hailu Dangisso

PLOS ONE, 2025, vol. 20, issue 2, 1-22

Abstract: Introduction: Accessing affordable and high-quality healthcare remains a persistent challenge in low- and middle-income countries like Ethiopia. Community-based health insurance (CBHI) programs offer a promising solution to expand healthcare coverage and provide financial protection, particularly for vulnerable populations such as women. This study aimed to investigate the factors that influence CBHI enrollment among women in Sidama National Regional State, Ethiopia, using a multilevel analysis. Methods: A community-based cross-sectional study was conducted using a multistage sampling technique from December 15th to January 12th, 2024, in the central Sidama zone, Sidama National Regional State. The study included 835 women aged 18 years and older, residing both in rural and urban areas. Face-to-face interviews were conducted using a pre-tested questionnaire to collect comprehensive data on socio-demographic, economic, and scheme-related factors. Data collection utilized the Open Data Kit mobile application, and data analysis was performed using Stata version 16, employing multilevel modified Poisson modeling to identify determinants of CBHI enrollment. Results: Among 845 samples, 835 women were interviewed, resulting in a response rate of 98.8%. Individual-level factors such as older age (APR = 1.02, 95%CI: 1.01–1.03, p

Date: 2025
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0316948

DOI: 10.1371/journal.pone.0316948

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