SynthesisBMC public health2023
Dropout rate and associated factors of community-based health insurance beneficiaries in Ethiopia: a systematic review and meta-analysis.
Synthesis in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Disparities in modern health service utilization between community-based health insurance member and non-member households in Ethiopia: a meta-analysis.BMC public health · 2026Pooled it
- Beneficiaries' satisfaction with health insurance and associated factors in Sub-Saharan Africa: a systematic review and meta-analysis.BMJ open · 2025Pooled it
- Stakeholder perspectives on the financial sustainability of community-based health insurance schemes in North Shewa Zone, Ethiopia: a qualitative study.Scientific reports · 2026Article
- Women's Intention to Maintain Enrollment in Community-Based Health Insurance: A Multilevel Analysis in the Sidama Region, Southern Ethiopia, 2024.Health services insights · 2026Article
- Household attitudes and associated factors toward community-based health insurance in the Awi Zone, Ethiopia: a community-based cross-sectional study design.BMC health services research · 2025Article
- Investigating membership attrition dynamics in community-based health insurance: a survival analysis of socioeconomic and program-specific determinants in the Amhara Region, Northwest Ethiopia.BMC public health · 2025Article
- Trust in the integrity of a micro health insurance scheme and its determinants in two rural districts of Ethiopia.BMC health services research · 2025Article
- Article
- Exploring Factors Influencing Family's Enrollment in Community-Based Health Insurance in the City of Gondar Peri-Urban Community, Northwest Ethiopia: A Health Belief Model Approach.Risk management and healthcare policy · 2024Article
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2 authors.
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Abstract
backgroundEthiopia aims to achieve universal healthcare using health insurance. To do so, it has been implementing community-based health insurance since 2011. However, the retention of members by the scheme has not yet been evaluated nationally. The systematic review and meta-analysis aimed to evaluate the dropout rate and associated factors among the scheme's beneficiaries in Ethiopia.
methodsOn December 19, 2022, searches were conducted in Scopus, Hinari, PubMed, Semantic Scholar, and Google Scholar. Searches were also conducted on the general web and electronic repositories, including the Ethiopian Health Insurance Service, the International Institute for Primary Health Care-Ethiopia, and various higher education institutions. The Joanna Briggs Institute's tools and the "preferred reporting items for systematic reviews and meta-analyses 2020 statement" were used to evaluate bias and frame the review, respectively. Data were analyzed using Stata 17 and RevMan 5. To assess heterogeneity, we conducted subgroup analysis and used a random model to calculate odds ratios with a p value less than 0.05 and a 95% CI.
resultsIn total, 14 articles were included in the qualitative synthesis, of which 12 were selected for the quantitative analysis. The pooled estimate revealed that the dropout rate of beneficiaries from the scheme was 34.0% (95% CI: 23-44%), provided that the renewal rate was 66.0%, and was found to be influenced by socio-demographic, health status, length of enrolment, knowledge, attitude, the scheme, and health service-related variables. The southern and Oromia regions reported the lowest and highest dropout rates, with 27.0% (95% CI: 24-29%) and 48.0% (95% CI: 18-78%), respectively. The dropout rates increased from 12.3% in 2012-2015 to 34.4% in 2020-2021.
conclusionMore than one-third of the scheme's beneficiaries were found to have dropped out, and this has been found to increase over time, dictating that a community-based strategy and intervention, from the supply, insurer, and demand sides, seem indispensable in minimizing this huge dropout rate.
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