Assessing Factors Associated with Poor Community Based Health Insurance for Client Satisfaction Level with Public Health Care Services in Negele Arsi District Health Centers, West Arsi Zone Ethiopia

Introduction: Community-Based Health Insurance (CBHI) schemes are emerging tool for providing financial protection for poor people living developing countries like Ethiopia. In Ethiopia, Community-Based Health Insurance (CBHI) was piloted in 13 districts and finally expanded to 427 districts, but satisfaction of community for the scheme and health service delivery is yet limited. Therefore, this study aimed to assess the satisfaction level of Community for health insurance. Methods: A facility based cross-sectional study design was conducted from March and April, 2019 in Arsi Nagele Woreda health centers. Three hundred ninety eight participants who visited the health care facility during the study period were included for the study. The data was entered to Epi-data version 3.1 and exported to Statistical Packages for Social Sciences (SPSS) version 21.0 for analysis Results: A total of 399 patients were participated in the study, yielding a response rate of 95%. 63.1% were male and 36.9% were females. The findings of the study showed that the overall client satisfaction level of CBHI with the health services received from the targeted health centers were 63.4%. Age, educational status, waiting time, drugs availability and knowledge were predictors for Clients satisfaction regarding service of community based health insurance. Qualitative dimension showed that the most unsatisfactory aspects for the Community Based Health Insurance (CBHI) health service were lack of skill personnel and availability of drugs at health facilities. Conclusion and recommendations: This study showed higher clients’ satisfaction level when compared to similar studies in the country. Young age, lack of drugs and supplies, poor information provision, long waiting time at consultation, were found to be the major predictors of dissatisfaction. Therefore, the district health offices should address and work on this predictor to regulate clients’ satisfaction for Community Based Health Insurance (CBHI).