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Barriers and facilitators to enrollment and re-enrollment into the community health funds/Tiba Kwa Kadi (CHF/TIKA) in Tanzania : a cross-sectional inquiry on the effects of socio-demographic factors and social marketing strategies

Kapologwe, Ntuli A. and Kagaruki, Gibson B. and Kalolo, Albino and Ally, Mariam and Shao, Amani and Meshack, Manoris and Stoermer, Manfred and Briet, Amena and Wiedenmayer, Karin and Hoffman, Axel. (2017) Barriers and facilitators to enrollment and re-enrollment into the community health funds/Tiba Kwa Kadi (CHF/TIKA) in Tanzania : a cross-sectional inquiry on the effects of socio-demographic factors and social marketing strategies. BMC health services research, 17. p. 308.

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Official URL: http://edoc.unibas.ch/55097/

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Abstract

Introduction of a health insurance scheme is one of the ways to enhance access to health care services and to protect individuals from catastrophic health expenditures. Little is known on the influence of socio-demographic and social marketing strategies on enrollment and re-enrollment in the Community Health Fund/Tiba Kwa Kadi (CHF/TIKA) in Tanzania.; This cross-sectional study employed quantitative methods for data collection between November 2014 and March 2015 in Singida and Shinyanga regions. Relationship between variables was obtained through Chi-square test and multivariate logistic regression.; We recruited 496 participants in the study. Majority (92.7%) of participants consented to participate, with 229 (49.8%) and 231 (50.2%) members and non members of CHF/TIKA respectively. Majority (90.9%) were aware of CHF/TIKA. Majority of CHF/TIKA members and non-members (90% and 68.3% respectively) reported health facility-based sensitization as the most common social marketing approach employed to market the CHF/TIKA. The most popular marketing strategies in the country including traditional dances, football games, radio, television, news papers, and mosques/church were reported by few CHF and non CHF members. Multivariate Logistic regression models revealed no significant association between social marketing strategies and enrollment, but only socio-demographics; including marital status (AOR = 2.0, 95% CI 1.1-3.8) and family size (household with ≥ 6 members) (AOR = 1.5, 95% CI 1.0-2.5), were significant factors associated with enrollment/re-enrollment rate.; This study indicated that low level of utilization of available social marketing strategies and socio-demographic factors are the barriers for attracting members to join the schemes. There is a need for applying various social marketing strategies and considering different facilitating and impending socio-demographic factors for the growth and sustainability of the scheme as we move towards universal health coverage.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Swiss Centre for International Health > Health Systems Support (Prytherch)
UniBasel Contributors:Stoermer, Manfred and Wiedenmayer, Karin Anne
Item Type:Article, refereed
Publisher:BioMed Central
ISSN:1472-6963
Note:Publication type according to Uni Basel Research Database: Journal article
Identification Number:
Last Modified:06 Jun 2017 12:07
Deposited On:06 Jun 2017 12:07

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