Evidence map›Paper›PMID 39905536›Full record

ArticleBMC health services research2025

Trust in the integrity of a micro health insurance scheme and its determinants in two rural districts of Ethiopia.

Mohammed Hussien

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Article in BMC health services research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

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1citing papers in PubMed
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1 · What the graph read from it

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3 · Its place in the literature

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1 citing paper in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

1 author.

Mohammed HussienDepartment of Health Systems Management and Health Economics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia. muhamedun@gmail.com.ORCID http://orcid.org/0000-0002-5747-8967

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMistrust in community-based health insurance schemes is a significant deterrent to enrollment and renewal decisions. Despite its significance, there is little evidence on the level of community trust in such schemes. This study examined the level of trust in the integrity of a community-based health insurance scheme and its determinants in two rural districts of northeast Ethiopia.

methodsA community-based cross-sectional study was carried out on 1,232 randomly selected rural households who had been registered in a community-based health insurance scheme. The data were collected through face-to-face interviews using an electronic data collection platform. Multivariable ordinal logistic regression analysis was performed using the partial proportional odds model to examine predictors of trust. The degree of association was assessed using odds ratios, and statistical significance was determined at a 95% confidence interval.

resultsThe mean score of the five trust dimensions was 5.86 on a scale of 0-10, ranging from 5.06 to 7.65. In the multivariable regression analysis, age (AOR = 1.58; 95% CI: 1.10, 2.29), female gender (AOR = 2.05; 95% CI: 1.29, 3.25), education (AOR = 1.36; 95% CI: 1.03, 1.80), insurance membership status (AOR = 2.68; 95% CI: 1.89, 3.80), membership duration (AOR = 1.51; 95% CI: 1.19, 1.92), value for solidarity (AOR = 1.71; 95% CI: 1.20, 2.45), perceived risk protection (AOR = 3.35; 95% CI: 2.27, 4.96), and perceived quality of care (AOR = 1.78; 95% CI: 1.34, 2.37) were positive predictors of trust in the integrity of the scheme, while wealth index (AOR = 0.33; 95% CI: 0.23, 0.47), and hospitalization history (AOR = 0.62; 95% CI: 0.48, 0.82) were negative predictors of trust.

conclusionsTrust in the integrity of the scheme received mediocre scores, with some trust dimensions having lower ratings, indicating specific areas of focus to be considered in trust-building. Scheme administrators and health authorities need to devise strategies to improve people's understanding of the basic principles of health insurance and promote access to high-quality care while minimizing expenditures at the point of receiving care.

Indexed as

Community-Based Health InsuranceRural PopulationTrustAdolescentAdultCross-Sectional StudiesEthiopiaFemaleHumansInterviews as TopicMaleMiddle AgedYoung AdultCommunity-based health insuranceFactorsIntegrityRural EthiopiaTrust

Identifiers

PMID39905536
PMCPMC11792196

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.