Data on community-based health insurance enrollment trends in northeast Ethiopia

Background The term "community-based health insurance" refers to
a broad range of nonprofit, prepaid health financing models designed to
meet the health financing needs of disadvantaged populations, particularly
those in the rural and informal sectors. Due to their voluntary
nature, such initiatives suffer from persistently low coverage in low- and
middle-income countries. In Ethiopia, the schemes’ membership growth has
not been well investigated so far. This study sought to examine the
scheme's enrollment trend over a five-year period, and to explore the
various challenges that underpin membership growth from the perspectives
of various key stakeholders. Results Over the course of the study period,
enrollment in the scheme at both districts exhibited non-linear trends
with both positive and negative growth rates being identified. Overall,
the scheme in Tehulederie has a relatively higher population coverage and
better membership retention, which could be due to the strong foundation
laid by a rigorous public awareness campaign and technical support during
the pilot phase. The challenges contributing to the observed level of
performance have been summarized under four main themes that include
quality of health care, claims reimbursement for insurance holders,
governance practices, and community awareness and acceptability. 
Conclusions The scheme experienced negative growth ratios in both
districts, indicating that it is not functionally viable. It will fail to
meet its mission unless relevant stakeholders at all levels of government
demonstrate political will and commitment to its implementation, as well
as advocate for the community. Interventions should target on the
highlighted challenges in order to boost membership growth and ensure the
scheme’s viability.