Awareness, Utilization and Satisfaction of Social Health Insurance Scheme among Residents of Letang Municipality, Koshi Province, Nepal

ABSTRACT Background: Social Health Insurance Scheme is a step towards attaining Universal health coverage. Health insurance program by government of Nepal has been scaled up nationwide to achieve one of the targets of Sustainable Development Goals by 2030. Ensuring the continued engagement of social health insurance scheme members remains a significant concern. This study aims to assess awareness, utilization and satisfaction of SHIS and the determinants for dropping out the scheme. Methods: A community-based cross sectional study was conducted including 527 participants who were permanent residents of Letang municipality. Five out of nine wards were selected randomly. A semi structured questionnaire was used to interview the head of household. Descriptive and inferential statistics were used. Binary logistic regression analysis was done to assess independent predictors. Results: Participants who were highly aware about the social health insurance scheme (SHIS) were 45.8% (215). Our study had SHIS enrollment rate of 73.24% (386) and utilization rate of 32.1% (124) whereas 16.6% (64) was dropout rate. 23.5% (124) of the participants were highly satisfied with the health services provided by SHIS. Age, gender and difficulty to pay SHIS cost had independent effect for dropping out of SHIS. Conclusion: One in ten participants had no knowledge at all of the SHIS. More than half of the insurer need services that weren't covered by SHIS. Expanding coverage and attaining universal health care can be accomplished through raising government health spending and allocating proceeds from an effective sin tax.