Health services utilization and associated factors among fee waiver beneficiaries' in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

Nigusie Tadesse; Amsalu Feleke; Muluken Genetu Chanie; Kidist Adamu; Asnakew Molla Mekonen

doi:10.1186/s12913-022-08963-7

Health services utilization and associated factors among fee waiver beneficiaries' in Dessie city administration, Northeast Ethiopia: a cross-sectional study design

BMC Health Serv Res. 2022 Dec 17;22(1):1544. doi: 10.1186/s12913-022-08963-7.

Authors

Nigusie Tadesse¹, Amsalu Feleke², Muluken Genetu Chanie¹, Kidist Adamu¹, Asnakew Molla Mekonen³

Affiliations

¹ Department of Health Systems and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia.
² Department of Health Systems and Policy, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia.
³ Department of Health Systems and Management, School of Public Health, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia. amdessie2007@gmail.com.

Abstract

Background: The fee waiver system is one of the components of the 2004 health care financing reform in Ethiopia. It is a system for granting access to health services to those who are unable to pay. The utilization health services among fee waiver beneficiaries remain low and unevenly distributed. This study aimed to assess the utilization of health services and associated factors among fee waiver beneficiaries in Dessie City, Northeast Ethiopia.

Methods: A community-based cross-sectional study design was employed in Dessie City from March 23 to April 23, 2021. The study was conducted among 407 fee waiver beneficiaries. A structured, interviewer-administered questionnaire was used to collect data. Participants were selected using a simple random sampling technique. Both bi-variable and multi-variable binary logistic regressions were performed. Significant factors for the outcome variable were identified at 95% CI with a p-value < 0.05.

Results: The overall health service utilization among fee waiver beneficiaries was found to be 62.4% (95% CI: 58.1-67.2). Being an urban resident [AOR:2.83, 95% CI:1.26-6.32], having a merchant occupation [AOR:0.20, 95% CI:0.05-0.80], having an average monthly income of 500-1000 birr [AOR:3.22, 95% CI:1.06-6.90], having a chronic disease [AOR:8.36, 95% CI:4.47-15.62], and perceiving the severity of illness as mild [AOR: 0.24, 95% CI: 0.07-0.81] were found to be statistically associated factors with health service utilization.

Conclusions: The fee waiver beneficiaries were not fully utilizing health services at public health facilities. Being an urban resident, being a merchant, having an average monthly income of 500-1000 birr, having a chronic disease, and perceived severity of illness were significantly associated with health service utilization. As a result, boosting income-generating strategies and urbanizing rural parts of the city may improve health service utilization among fee waiver beneficiaries.

Keywords: Dessie; Ethiopia; Fee waiver beneficiaries; Health service utilization.

MeSH terms

Chronic Disease
Cross-Sectional Studies
Ethiopia
Facilities and Services Utilization*
Humans
Patient Acceptance of Health Care*