Willingness to pay for community based health insurance scheme and factors associated with it among households in rural community of South West Shoa Zone, Ethiopia

Multidimensional determinants of willingness to pay for community-based health insurance in Ethiopia and its implication towards universal health coverage: A narrative synthesis

Pooling resources to pay for healthcare services and attain universal health coverage is a viable global agenda, especially for underdeveloped health systems. Ethiopia has implemented community-based health insurance (CBHI) since 2011 to improve healthcare funding. However, comprehensive evidence on the demand and determinants of health insurance in Ethiopia is lacking. Therefore, this review aimed at identifying determinants of willingness to pay (WTP) for CBHI in Ethiopia. A narrative review was conducted using search terms from PubMed, Science Direct, Scopus, African Journal Online, and Google Scholar databases. Screening process considered publication year, settings, English language, and study participants. Newcastle Ottawa tool assessed the quality of included studies. A thematic framework was applied. The review protocol was registered in PROSPERO with an ID number CRD42022296840. The review included 10 studies. The synthesis identified 25 determinants of WTP for CBHI in Ethiopia. Socio-demographic and economic, scheme-related, and health-related determinants of WTP for the CBHI were identified. Determinants of household WTP for CBHI in Ethiopia were multi-dimensional. Socio-demographic, socio-economic, scheme-related, and health-related factors are among the common determinants documented. CBHI is thus an alternative and potential source of financing for the healthcare system, primarily for people with low socioeconomic status and a fragile health system. The health system, socioeconomic leaders, and political figures play a significant role in influencing communities towards WTP for CBHI while increasing government spending on health toward UHC.

Parenting and parenting resources among Chinese parents with children under three years of age: rural and urban differences

BACKGROUND

Parenting is essential for children's development and preventing child abuse and neglect. Providing parenting services within the primary health care settings demonstrated effectiveness in improving parenting quality. However, little is known about the status of parenting and parenting resources in rural areas and whether they differ between rural and urban areas in Mainland China.

OBJECTIVE

This study aimed to examine the rural-urban differences in parenting and availability of, utilization of, and need for parenting resources among Chinese parents with children under three years of age.

PARTICIPANTS AND SETTING

A total of 425 parents of children under three years of age participated in an online survey between March and May 2020.

METHODS

The Parenting and Family Adjustment Scale and Child Adjustment and Parenting Efficacy Scale were used to assess parenting, family adjustment, and parenting efficacy. The availability of, utilization of, and need for parenting resources were measured using self-developed questions based on literature. Chi-square tests, t tests, and Wilcoxon rank-sum test were used to examine the differences in responses between parents in rural and urban areas.

RESULTS

Compared with their urban counterparts, rural parents reported a higher level of negative parenting and more limited parenting resources. Both rural and urban parents reported low availability and utilization of parenting resources as well as a great need for parenting support services.

CONCLUSIONS

Rural parents faced more parenting challenges and limited parenting resources compared with urban parents. Both rural and urban parents with children under three years of age reported great needs for parenting resources. These findings highlight the potential of delivering accessible, sustainable, and cost-effective parenting programs via the primary health care system for public welfare in both urban and rural areas, with more attention paid to rural parents to help them improve their parenting.