Poverty and Household’s Healthcare Decision-Making Behavior: Evidence from North Shoa Zone, Amhara Region, Ethiopia

Dr. Muhammed Siraj
Deparmnet of Economics, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia

Dr.Kidane Kerebih
Department of Accounting and Finance, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia

Dr. Sisay Mulate
Deparmnet of Accounting and Finance, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.

Abstract

Poverty constrains poor households from accessing healthcare services especially in developing economies. This study explored the influence of poverty on households' healthcare insurance decision-making behavior through households' participation in the Community-Based Health Insurance (CBHI) scheme in four purposively selected woredas of North Shoa zone, Amhara region, Ethiopia. A quantitative research approach was employed. Primary data was obtained by convenience sampling from 356 sample households through a semi-structured questionnaire for empirical analysis. Both descriptive and binary logistic regression methods of data analysis were applied. The study finds being a household above poverty line is less likely to join the CBHI [AOR=0.003, p<0.05]. In addition, head of household’s age [AOR=1.551, p<0.05], marital status [AOR=1.011, p<0.05], year of schooling [AOR=1.937, p<0.05], perceived health service quality, scope and adequacy [AOR=54.820, p<0.05], and awareness about the scheme [AOR=408.795, p<0.05] have positive and significant influence on households’ decision to participate in the CBHI scheme. Moreover, household’s family size [AOR=7.996, p<0.05], and previous year's annual health expenditure [AOR=1.005, p<0.05] have positive and significant influence on households’ decision while distant households to the nearest public health institutions [AOR=0.421, p<0.05] are found less likely to join CBHI. More importantly, this study found that poverty is a pertinent factor in influencing households’ healthcare decision-making behavior among other socioeconomic, demographic, and institutional factors. This suggests that the CBHI scheme in Ethiopia should prioritize being more pro-poor to ensure health equity and reduce healthcare financial risk by improving accessibility, building community trust, and raising awareness, as ensuring healthy households is crucial for breaking the poverty cycle.

Keywords: Poverty, Decision-making, Healthcare, CBHI, Ethiopia.

Author Biographies

Dr. Muhammed Siraj, Deparmnet of Economics, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia

Dr.Kidane Kerebih, Department of Accounting and Finance, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia

Dr. Sisay Mulate, Deparmnet of Accounting and Finance, Debre Berhan University, P.O. Box 445, Debre Berhan, Ethiopia.