Household satisfaction with community-based health insurance scheme and associated factors in Addis Ababa, Ethiopia, a mixed method approach

Around half of households were satisfied with the community-based health insurance (CBHI) scheme. Household satisfaction was significantly associated with marital status, educational level, knowledge of CBHI benefit packages, receipt of correctly prescribed drugs, participation in CBHI-related meetings, presence of qualified health professionals, availability and sanitation of showers and toilets, and satisfaction with the permitted health institutions. Qualitative findings further highlighted barriers to satisfaction, including limited awareness of CBHI services, lack of respectful and compassionate care, shortages of medications, laboratory and diagnostic services, and difficulties with premium payment modalities. To enhance the sustainability of the community-based health insurance scheme, it is recommended to strengthen the supply chain for essential medicines, improve communication and awareness among CBHI members, and enhance the responsiveness and quality of care provided by health professionals.